Other Resources
On-Line white papers and other RM information
White Papers
The following information is available for download/printing. All are in a PDF format. (Click here to download Adobe Reader if you have trouble opening the PDF documents.)
- Office Based Anesthesia Guidelines
(PDF) - Guidelines on Terminating the Doctor/Patient Relationship (PDF)
- Introducing New Procedures in the Office (PDF)
- Sample Physician Withdrawal Letter (PDF)
- Communication and Restrictions of Private Health Information (PDF)
- What is Informed Consent? (PDF)
- Authorization to Release Medical Information (PDF)
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Risk Management Spotlight
What do you do when a previously terminated patient shows up in the emergency department when you're on-call?
The decision to terminate the patient-physician relationship is not one that is taken lightly by most physicians. When you have determined that this significant action is necessary and have gone through the process to properly terminate the relationship, it can be disconcerting to be on-call for the emergency department where this previously terminated patient shows up. What should you do in this situation?
When covering the emergency department, the on-call physician must provide care to the emergent patient even if the patient happens to have been terminated from the physician's private practice. However, if the on-call physician covering the emergency department can have another physician see the patient without delay impacting the treatment of the patient's emergency condition, then it is permissible to transfer care to another physician. In such a circumstance, the physician covering must document in the medical record that another physician of like specialty is immediately available, has been consulted, and has agreed to immediately assume patient care responsibility. The other physician must be specifically identified in the record and the time of the transfer of care must be noted. This must be recorded in the progress notes and confirmed in a physicians order in the chart. There must not be an interruption in the continuity of care for the emergency patient! This is a dangerous situation from a liability standpoint (PATIENT ABANDONMENT ISSUES) and should be reserved for use only in the most unusual circumstance where the prior termination of the patient-physician relationship could impact the ability to provide emergency care! Once the patient's emergency is stabilized, the process for terminating the relationship is the same as terminating the patient-physician relationship in the office, except you must make certain that another physician has assumed care of the patient in the hospital up until discharge.
You can go to Risk Management Resource Library for guidelines on terminating the patient-physician relationship (Guidelines on Terminating the Doctor/Patient Relationship and a sample termination letter (Letter of Physician's Intent to Terminate Patient Relationship). Contact the risk management department by email at riskmanagement@api-c.com or by phone at (800) 252-3628 if you have questions regarding the patient-physician termination process.
This information is for educational purposes only. The contents are neither intended to represent the "standard of care" for the practice of medicine, nor to be regarded as legal advice for any specific factual situation. If legal, medical or other professional advice is required, the services of a competent professional person should be sought.
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Hotline: On-Demand Answers
Physicians and managers call or email API risk management for immediate assistance with issues including: patient complaint, difficult patient, responding to a Texas Medical Board notice letter, medical/legal advice on medical records, consent, confidentiality, minors.