Sample Medical Termination Letter

Posted in Termination Letters

Ending the patient-doctor relationship is a task no physician looks forward to, but it is one that is sometimes necessary. When a doctor decides treating a patient is no longer in the best interest of either party, the patient should be notified of the decision in writing via a medical termination letter.

Format and Content
Draft the letter using a professional tone and wording that is respectful to the patient. The medical termination letter format should include a reason for the termination, the date of the termination, and the amount of time you will continue to provide care for the patient. Include supporting evidence for the decision, especially if the decision is based on the undesirable actions of the patient. The letter should include a statement regarding the handling of the patient’s medical records and the name of a physician referral resource. Send the letter by certified mail with a return receipt requested.

This medical termination letter sample is written by a physician who believes his patient is ignoring medical advice. The patient is engaging in behaviors that threaten to worsen her current medical condition. The doctor feels ethically obligated to terminate the doctor-patient relationship in hopes that the patient will find a physician who is able to convince her to follow medical advice.

June 20, 2013
Dr. Stephen Shay
Cedar Springs Medical Associates
2650 Cedar Springs Rd.
Knoxville, TN 73257
Ms. Tracy Jordan
360 West Campbell Rd.
Knoxville, TN 73257
Dear Ms. Jordan,
It is my belief that the relationship between a physician and patient is an essential aspect of quality medical care. If trust and communication are missing, it limits my effectiveness as a physician. Unfortunately, I feel that these critical elements are missing in our doctor-patient relationship. As my primary concern is for your health and well-being, I believe it is in your best interest to seek the services of another physician. As of July 1, 2013, I will no longer serve as your primary care physician.
As we have discussed on numerous occasions, I believe strongly that you should refrain from certain activities in order to return to full health. While I realize your leg injury was a devastating blow to your career, I sincerely believe the injury will heal if you follow medical advice. Following your surgery, I specifically recommended that you refrain from walking on the leg for a period of 1 week. I asked you to use crutches during your rehabilitation and to utilize the services offered by a rehabilitation clinic. Although rehabilitation is covered by your insurance policy, you chose to ignore my advice.
During your appointment on June 18, 2013, you informed me that you had engaged the services of a professional trainer. This trainer has recommended prolonged and intense workouts that I strongly feel may cause irreparable damage to the muscles and joints involved in your injury. As I have communicated to you repeatedly, your injury will require time to heal and the care of a trained rehabilitation professional. It is my belief that you are relying on pain medications to engage in the activities recommended by the trainer you hired. Aside from allowing you to hurt yourself further, these medications are addictive and I will not honor future refill requests.
I encourage you to seek a new primary care physician as soon as possible. I will continue to serve as your physician until July 1, 2013. Following this date, I will treat you on an emergency basis only through the end of July 2013. You may contact the Knoxville Medical Association for a referral for a new physician. I will be happy to send a copy of your medical records to your new doctor provided you sign and return the medical release form included with this letter. I wish you all the best going forward.
Stephen Shay
Dr. Stephen Shay
Cedar Springs Medical Associates
Encl: Medical Release Form
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