The proper maintenance of patient panels plays a pivotal role in improving access to medical care to those who need it most and ensuring patients are not dismissed unethically.
As outlined in the ’s Ending the Patient-registrant Relationship practice standard, in cases where the therapeutic relationship becomes ineffective, registrants may terminate their relationship with a patient. This includes instances where a patient has been inactive for a prolonged period―often spanning several years.
In these circumstances, it may be appropriate for registrants to terminate the treating relationship with the patient to free up space for new patients who urgently need primary care. However, when doing so, registrants are expected to adhere to the CMA , which states that:
Having accepted professional responsibility for the patient, physicians must continue to provide services until these services are no longer required or wanted, until another suitable physician has assumed responsibility for the patient, or until after the patient has been given reasonable notice that they intend to terminate the relationship.
Registrants must make reasonable attempts to contact an inactive patient before dismissing them from their patient panel, including phone calls, emails, and written correspondence. Patients must be informed about the potential discontinuation of their care and should be provided with an appropriate length of time to respond, and the option to remain on a panel if reasonable (i.e. they are still living in the community).
The does not define a “prolonged period of time” of patient inactivity, nor does it define an “appropriate length of time” for registrants to wait for a patient’s response before dismissing them. The diversity of practice settings across the province makes it challenging to establish one-size-fits-all expectations.
In all cases, registrants are expected to use their best judgement and make careful decisions that consider their patient’s needs. The rationale for the decision to end the patient-registrant relationship and attempts to communicate with the patient should be documented in the medical record.
Registrants are strongly advised to have a practice policy in place for dismissing patients due to inactivity and ensure the policy is clearly communicated to patients. Applying a standard approach helps ensure that terminating the patient-registrant relationship is done consistently and equitably, and not based on factors that may be considered discriminatory under the BC Human Rights Code.
Questions regarding this article can be directed to communications@cpsbc.ca.
More information on ending the patient-registrant relationship is available in this online course. The course takes five to 10 minutes and includes steps to take to end the patient-registrant relationship.
