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What You Need to Know About Patient Abandonment

March 1, 2021
Doctor And Patient's Hands — Los Angeles, CA — Spiga and Associates

Sometimes a doctor-patient relationship doesn't work out. Maybe a patient owes payment for six months of service. Maybe they've become unruly or won't comply with medical advice, or perhaps it's as simple as your retirement and the need to close your practice. No matter the reason for terminating the relationship, you must handle it correctly.


California laws allow a physician to stop seeing a patient as long as the decision doesn't involve discrimination or prejudice, but you'll need to follow proper procedures. Without them, the Medical Board of California can charge you with unprofessional conduct for patient abandonment. In such instances, you may need to hire a medical license defense attorney to protect your license.


What California Law Considers Patient Abandonment


California defines patient abandonment as terminating the relationship without written notice to the patient. By law, the patient must have enough time to find another physician. If they decline further treatment or consent to the termination, however, they cannot legally claim abandonment. Instances when a patient can file a complaint include:


  • You end the relationship without providing a reasonable opportunity for the patient to find a new doctor
  • You verbally express to the patient that you won't treat them anymore but don't follow up in writing
  • You won't schedule a follow-up with a non-compliant patient but you haven't followed the legal steps for termination
  • You won't schedule a follow-up with a patient who owes back payments but you haven't properly discharged them
  • You close your practice without giving your patients notice or instructing them on how they can retrieve their medical records


If the Medical Board of California (MBC) decides that you abandoned your patient, they may put you on probation, or even suspend or revoke your license. Not only that, but the patient can sue you for medical malpractice if they feel their abandonment caused them harm.


How You Can Avoid an Unprofessional Conduct Claim


To avoid ending up before the MBC for patient abandonment as a form of unprofessional conduct, you must follow certain legal steps. They recommend the following to prevent allegations:


  • Provide written notice of the termination date
  • Give the patient at least 15 days to get emergency treatment and medication
  • Provide written recommendations of other practices where the patient may seek care
  • Instruct the patient of specific steps they need to take to obtain their medical records


If you have written proof that you did everything possible for that patient to find adequate medical elsewhere, any claim they may file against you isn't likely to hold.


What to Do If You're Contacted By a Medical Board Investigator


If you receive a letter or call from a Board Investigator, assume there was a complaint filed against you. Don't offer them information without your lawyer present. No matter how friendly they may seem, remember that their job is finding evidence to use against you.



To have the best chance of beating a patient abandonment allegation, contact an attorney as soon as you get that first phone call or letter. With legal assistance, you may be able to resolve the issue at the interview stage. A lawyer will advocate that they close the complaint in a manner that allows you to keep your license.


When you make the uncomfortable decision to terminate your relationship with a patient, be careful and follow legal procedures to avoid allegations of unprofessional conduct. If a patient still files an abandonment complaint against you with the medical board, Spiga & Associates can help. Call us today for assistance. We'll fight to protect your license and your livelihood so you can continue providing excellent care.

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CALIFORNIA PHYSICIANS DEFENSE ATTORNEY: SCHEDULE II SUBSTANCES

By Carlo A Spiga, Lead Attorney • February 24, 2021
You see him or her on your television, in your professional journals, and on your home page . . . the “Poster Child.” The Physician existing on the fringe of the profession, who gets arrested for overwriting prescriptions for Schedule II substances . Their example is easy to dismiss. The average M.D. engaged in legitimate practice seemingly has nothing to worry about. This fate befalls the slacker, the greedy, the foolhardy. Don't be so sure, any M.D. who prescribes Schedule II substances as a regular part of their practice is only one adverse patient outcome away from California Medical Board and possibly criminal investigation. For example, Surgeons and Physicians practicing in Emergency Medicine, Oncology, and Pain Management, routinely write hundreds, if not thousands of prescriptions for Schedule II substances. There is no way for a Physician to control the patient’s use of controlled substances, yet a dangerous and influential myth is being propagated that a physician is a fortune teller and can predict which patients will misuse the substances provided. Further complicating the issue is the difficult ethical landscape navigated by Physicians dealing with patients presenting legitimate symptoms demanding treatment with Schedule II and III substances, but who are nevertheless, drug dependent. Long term pain management patients are at particular risk of overdose due to their high tolerances leading to increasing dosages and the difficulty in weaning them off the substances they have become dependent upon. Should a patient die or suffer an adverse outcome that is somehow connected to a prescription for a schedule II substance, a criminal and California Medical Board investigation is sure to follow. Oftentimes the investigation will be spearheaded by investigators for the California Department of Consumer Affairs working in conjunction with local law enforcement but who also work on behalf of the Medical Board of California. These investigators are sworn peace officers and have the power to arrest and working with the Attorney General or local District Attorney also have the ability to bring criminal charges against a Physician. These investigations start out invisibly with scrutiny of CURES II reports detailing a Physician’s prescription history. All patients receiving scheduled substances will be given particular attention. Soon after, the physician will receive a request for patient records, followed by a letter of investigation from a California Department of Consumer Affairs Investigator indicating that a complaint has been made and requesting an interview. They do not inform the Physician of his or her right to counsel or whether the Physician even has the right to refuse the interview. Nor do they inform him or her of their right to review the complaint. Believe it or not, one of the common mistakes Physicians make in dealing with these investigations is not taking it seriously. They will delay responding or not respond at all. Often Physicians confident in their prescribing practices will have a false sense of confidence going in to such an interview and will wing it without consulting consul. Those Physicians learn the error of that approach through hard experience. If you are facing such an inquiry. Take it very seriously, Your medical license is your most important asset. If you have an adverse patient outcome that has come to the attention of your Hospital Administration, The Medical Board of California or local law enforcement, call Spiga and Associates immediately. Because of our 25 years of experience in both Criminal and Administrative defense we are uniquely qualified to defend you and your medical license.
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