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Dental practice patient dismissal: when, and how to proceed

Read this before dismissing a patient from your practice

Team Wisdom

Patient dismissals are never taken lightly in the dental community, as saying goodbye to a patient isn't just about crossing off a name on a list. It's more than verbally declining to schedule any more appointments for them. It's a careful balancing act between ethical considerations and legal requirements to maintain the integrity of the dentist-patient relationship. Practices must also be mindful of avoiding patient abandonment. 

3 of the top reasons your practice may consider a patient for dismissal:  

- Financial non-compliance, including failure to adhere to payment agreements

- Multiple violations of your written appointment cancellation policy 

- Hostile behavior towards dental staff

Before taking dismissal action, however, the following should be considered, as patient dismissal will be a last resort: 

Have you provided, or attempted to provide, clear reasoning, and/or a warning to the patient before taking action?

If the reason is financial, or due to your cancellation policy, do you have signed informed consents from the patient that outline these office policies?

Have you documented internally what has led to the necessity for the termination, and how you conveyed it to the patient? 

Does the patient have pending treatment, or are they in pain?  This doesn't mean completing an entire treatment plan. For instance, it's wise to finalize procedures like cementing a crown, addressing symptomatic teeth, or fitting permanent dentures. If a patient is in severe pain, or facing a life-threatening condition, it might not be the appropriate time to dismiss them.   

To execute this termination ethically, a certified letter serves as a formal notification. This letter, drafted with clarity and professionalism, specifies the termination date and provides a transparent explanation for the decision. It also outlines emergency protocols, communicates the patient's current dental status, treatment recommendations, and the risks associated with discontinuing care. Additionally, it facilitates the transfer of dental records, offers guidance on seeking alternative dental care, and addresses any outstanding financial obligations. Store a copy of the dismissal letter, and proof they received it in their chart. 

It's imperative to ensure that the termination of the dentist-patient relationship is not based on discriminatory grounds, such as age, race, or disability. Transparency is key, particularly when temporary dental restorations are involved, to mitigate potential risks and ensure patient understanding.

Patient abandonment laws can vary state to state - ensure you know and understand your informative and treatment obligations. Oftentimes - with great conflict resolution and trained staff, non violent incidents that motivate a dental practice team ponder dismissing a patient can be diffused, and the relationship salvaged. Good treatment planning and treatment case presentation can prevent account balance issues.

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