Patient Noncompliance

Patients who fail to comply with treatment recommendations cannot expect the treating physician to be responsible for the outcome of care. The patient’s failure to comply, called noncompliance, can compromise his health. Physicians are responsible for treating a patient once a medical chart has been established. A contract is in effect when a patient seeks and receives treatment. The physician, by agreeing to treat the patient, fulfills his portion of the contract by:

1) diagnosing and treating the patient to the best of his ability
2) being available to the patient for care and return phone calls
3) arranging for a different physician to be available in the event of the physician’s absence.

The patient is responsible for his portion of the contract in that he agrees to pay copayments, provide insurance information to the office, and comply with treatment recommendations. If a physician suggests treatment and the patient refuses that treatment, the patient’s chart should reflect that the patient has been informed of the physician’s recommendations but has decided not to comply. Patients have the right to refuse treatment, but the physician is no longer responsible for the outcome. It is reasonable for a physician to expect a patient to:

1) truthfully relate his medical history
2) follow treatment recommendations, including medication, physical therapy, and lifestyle changes
3) keep scheduled appointments
4) pay copayments or deductibles as agreed.

Either party may end the patient-physician relationship. If a physician feels that the relationship must end, the medical assistant should send a registered letter to the patient to document the severing of the physician-patient relationship.
If a physician were not to write a letter of formal discharge to the patient, but merely refused to see the patient again, the physician can be charged with abandonment and could be held responsible for the poor outcomes of the patient’s condition due to a lack of care.