What is Patient Abandonment?

Patient abandonment is a form of medical malpractice that occurs when a physician terminates the doctor-patient relationship without reasonable notice or a reasonable excuse, and fails to provide the patient with an opportunity to find a qualified replacement care provider.

In this article, we'll look at the elements that typically define patient abandonment, and we'll explore a few scenarios that could qualify as patient abandonment in the health care setting.

The Elements of Patient Abandonment

Let's start by pointing out that whether or not patient abandonment has occurred is a very fact-specific issue, and a doctor's potential legal liability can vary from state to state. Having said that, there are certain common elements among patient abandonment cases:

• First, the doctor-patient relationship must be established. This means that the physician must have agreed to treat the patient, and treatment must be underway.
• Second, the abandonment must take place when the patient is still in need of medical attention -- this is known as a "critical stage" of the treatment process.
• Third, the abandonment must have taken place so abruptly that the patient did not have enough time or resources to find a suitable replacement physician to take over treatment.
• Finally, the patient must suffer an injury as a direct result of the patient abandonment.

Examples of Patient Abandonment

There are many real-world situations in which a doctor might terminate a relationship with a patient without a reasonable excuse.

For example, if a doctor intentionally refuses to treat a patient who has failed to pay his or her medical bill, that is often considered unjustified. And if a doctor is unavailable for an unreasonable amount of time when a patient needs medical care -- and so is the backup (or "on call") doctor -- that could amount to patient abandonment if the patient ends up suffering harm as a result.

It should be noted that patient abandonment can also occur between other kinds of health care providers and the patient -- not just between the physician and the patient. For example, if a nurse-patient relationship has been established, and the same legal elements we discussed above are present, then the patient may have a valid medical malpractice claim based on patient abandonment.

Patient abandonment can also occur when:

• the hospital has inadequate staffing
• the medical staff fails to reach out to a patient who has missed an important follow-up appointment
• the medical staff fails to communicate an urgent question from the patient to the doctor, or
• the medical staff schedules an appointment too far in the future, resulting in preventable harm to the patient as their condition worsens.

When It's Not Patient Abandonment

Not every situation where a doctor stops treating a patient leads to an actionable claim for medical malpractice. Most don't, in fact.

Valid reasons to end a doctor-patient relationship include:

• the doctor has insufficient skills to provide adequate treatment to the patient
• there are insufficient supplies or resources to provide adequate treatment to the patient
• ethical or legal conflicts arise during the treatment process
• the patient violates the physician's policies
• the patient has numerous cancelled or missed appointments
• the patient refuses to comply with the physician's recommendations, and
• the patient demonstrates inappropriate behavior, such as making sexual advances or engaging in verbal abuse.

If a valid reason exists, then the physician can take steps to terminate the relationship in an appropriate manner, and attempt to avoid liability. That means, the physician should provide the patient with written notice of the termination along with a valid reason for the decision. The physician should continue to treat the patient for a reasonable period of time to allow the patient to arrange for alternative care from another competent physician. The physician should also recommend another qualified physician. Finally, once the patient has secured another physician, and has signed an authorization, the physician must transfer the patient's medical records to the new physician in a reasonable and timely manner.