Section Title: Rutgers Robert Wood Johnson Medical Group (Rutgers RWJMG)



Similar documents
Guidelines for safely dismissing a patient from the practice include:

6325 Hospital Parkway Johns Creek, Georgia Phone emoryjohnscreek.com Dear Provider,

Keweenaw Holistic Family Medicine Patient Registration Form

The Healthy Mind PSYCHIATRIC SERVICES

Two Medical Schools, Two Unique Faculty Practice Plans, Two Compliance Officers, One University Under a CIA: A Compliance Program Challenge

Please fill out the new patient paperwork and bring it with you, along with a photo ID and health insurance or Medicare card.

3/17/2015. Disclaimer. Objectives

Wayne Physical Medicine & Rehabilitation Associates 401 Hamburg Turnpike, Suite 105 Wayne, NJ 07470

ATHLETIC PARTICIPATION MEDICAL PACKET (SOPHOMORES)

Make the Switch Checklist

Faculty Group Practice Patient Demographic Form

The Clarity Psychological Group 3915 Cascade Rd. SW Suite 250 Atlanta, GA P. (404) F. (404)

internet internet website: website: Fax: Fax:

Warner Family Counseling

New Patient Intake Package

CODE OF ETHICS For Certified Psychiatric Rehabilitation Practitioners, Approved September 28, 2012

X Guarantor/Parent/Guardian Signature

Retention in the Athletic Training Major

Office Policies Dear Patient: We would like to take the opportunity to explain the policies of our office. Please take notice of the following:

Administration A. Superintendent 1. Student Teacher University Agreement Template

Patient Information Form Trinity Wellness Center. Insurance Information

Sincerely yours, Rev

Athens Neuro & Balance Rehabilitation

Policy and Procedure Manual

NHA Certified Medical Administrative Assistant (CMAA) Test Plan (Detailed)* 110 scored items, 20 pretest items Exam Time: 2 hours 10 minutes

Selling/Closing a Medical Practice

Rule 5.2 Definitions. For the purpose of Chapter 5 only, the following terms have the meanings indicated:

Vermont Board of Nursing INSTRUCTION TO APPLICANTS

POUGHKEEPSIE CITY SCHOOL DISTRICT PUPIL PERSONNEL DEPARTMENT S MEDICAID BILLING COMPLIANCE PROGRAM AND PROCEDURES

AUBURN MEMORIAL MEDICAL SERVICES, P.C.

UMDNJ Robert Wood Johnson Medical School MD/PhD Program 07-08

RICH TOWNSHIP HIGH SCHOOL Adopted: 7/10/00 DISTRICT 227 Olympia Fields, Illinois

Initial Credentialing Application: Certified Registered Nurse Anesthetist (CRNA)

PATIENT TRANSFER AGREEMENT

SUSPENSION, RELOCATION OR CANCELLATION OF ACADEMIC CREDENTIALED PROGRAMS

Quiroz Adult Medicine Clinic, P.A. General Office Policies

Releasing Information

NHA Certified Medical Administrative Assistant 2015

DEPARTMENT OF HEALTH CARE FINANCE

THE WORLD OF PEDIATRICS. Medical Records/Health Information Release (Please fill out and fax or send to your current practice or pediatrician)

DISCOVERY IN GEORGIA WORKERS COMPENSATION CLAIMS

LHMU Accidental Dental Claim Form

RICHARD S. ADLER, M.D. Forensic & Clinical Psychiatry PRACTICE DESCRIPTION AND LETTER OF AGREEMENT DESCRIPTION OF PRACTICE

Degree Application Enrollment Application for Associate s Degree of Applied Business (A.A.B) in Business Management Name:

SUBSTANCE ABUSE OUTPATIENT

There are no application fees to be granted the MATC, although you will need to pass the on-line MATC Exam or complete the MATC Education Course.

Submission of the Criminal Offender Record Information Request Form (CORI).

Combined Bachelor s/master s Program Department of Civil and Environmental Engineering

Office of Human Resources. Xavier University of Louisiana Staff Employee Handbook

BREINING INSTITUTE 8894 GREENBACK LANE ORANGEVALE, CALIFORNIA USA TELEPHONE (916)

Thank you for having applied to a Pain Medicine Subspecialty Residency.

College of Physicians and Surgeons of Saskatchewan LEAVING PRACTICE. A guide for physicians and surgeons

Charlotte Therapy Associates, PLLC Diane Yee, MS, LPC Professional Disclosure Statement

Marci Danielson, M.S., LMFT COUNSELING GUIDELINES, RIGHTS AND RESPONSIBILITIES

PATIENT REGISTRATION Date:

CHAPTER NURSE AIDE TRAINING, COMPETENCY EVALUATION, AND REGISTRY

Carefully read the following instructions for completing the respiratory therapist license application.

Medical Staff Services. Dear Applicant,

KENTUCKY. March 10,2011. Jeannine Blackwell, Dean Graduate School University of Kentucky Campus, Dear Dean Blackwell,

APPENDIX E. Summary of the Texas Physician Assistant Licensing Act. University of Texas Southwestern Medical Center June 2001

All routine calls will be be returned within hours, in in the order in in which they were received.

UNIVERSITY OF HAWAI I EXECUTIVE POLICY - ADMINISTRATION

State Medical Board of Ohio 30 E. Broad Street, 3rd Floor, Columbus, OH (614) med.ohio.gov

UCP CENTRAL PA ABUSE/NEGLECT POLICY

BUSINESS AND PROFESSIONS CODE SECTION

Drug and Alcohol Testing

123 W. Washington St., Suite 321 Oswego, IL Phone:

Medical Terminology for Interpreters Training of Trainers

Application for Admission to a Higher Degree by Research International

ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES

To identify graduate programs and chairpersons please visit our web site at

READ ONLY COPIES (These forms to be completed in the doctor s office at time of visit)

Pediatric Outpatient Rehabilitation Services

Mandatory Reporting of Child Sexual Abuse in Western Australia

Handbook for Persons with Disabilities

FNRE Scholarship Application

Goodman Fielder Income Protection Claim Form

CODE OF ETHICS FOR COGNITIVE REHABILITATION THERAPISTS

2015/2016. Heart and Stroke Foundation New Investigator Awards Guidelines Alberta. (Winter 2014 Competition)

Student Health Forms

Patient Registration Form

Early Intervention Central Billing Office. Provider Insurance Billing Procedures

2. Electronic Health Record EHR : is a medical record in digital format.

PRO SPORTS THERAPY, INC. (P.S.T.)

ICM Brokers. Introducing Broker Agreement

Transcription:

Section: Rutgers Robert Wood Johnson Medical School Section Title: Rutgers Robert Wood Johnson Medical Group (Rutgers RWJMG) Policy Name: Terminating a Physician-Patient Relationship Policy Formerly Book: Approval Authority: Rutgers RWJMG Board of Directors Responsible Executive: President, Rutgers RWJMG Responsible Office: Rutgers RWJMG Practice Administration Originally Issued: 9/13/2012 Revisions: 12/18/2014 Errors or changes? 1. Policy Statement The purpose of this policy is to provide guidance to RWJMG Attending Physicians for managing interactions with patients when the patient-physician relationship is not maximal and to outline the process for terminating a patient from an individual Provider, Department/Division, or the entire practice. Legal, ethical and risk management best practices have been considered in developing this policy. 2. Reason for Policy As noted in the Robert Wood Johnson Medical Group (RWJMG) Mission Statement: The Robert Wood Johnson Medical Group is dedicated to providing the highest quality medical care, with respect and compassion for our patients, in a safe and efficient manner, in support of the teaching, research, and community outreach missions of the UMDNJ-Robert Wood Johnson Medical School. We must also recognize that our mission is not that of a private medical practice, but rather a public institution with a mandate to ensure the health of New Jersey residents. Relationships may be terminated by the patient or the physician. Under most circumstances, a physician has the right to terminate the patient-physician relationship, so long as the patient is notified in writing and given sufficient time to engage the services of another physician. The theory of abandonment and medical ethics require

that once a patient engages a physician, that physician is under an obligation to provide the patient with continuous care and attention until the relationship is properly terminated. Terminating a patient-physician relationship can be difficult for the physician and the patient. Studies have shown that patients view termination in a very negative light. 3. Who Should Read This Policy All faculty and staff of the Rutgers RWJMG. 4. Related Documents Terminating a Physician-Patient Relationship Procedure Appendix A: Terminating a Patient from an Individual Provider letter Appendix B: Terminating a Patient from a Department/Division letter Appendix C: Terminating a Patient from Rutgers RWJMG letter (entire practice) 5. Contacts Office of the Dean, RWJMS (732-235-6300) 6. The Policy It is the position of the RWJMG that every reasonable effort shall be undertaken to rehabilitate the patient-provider relationship in order to avoid termination. When termination has been deemed necessary, it must be decided whether to terminate from an individual Provider, Department/Division, or whether the termination applies to the entire practice. In instances of frequent no-show, cancellations, or non-adherence with recommended medical treatment plans, every reasonable effort will be undertaken in order to avoid discharging the patient. Other occurrences may lend themselves more to termination from an individual Provider or Department/Division, such as a patient who is not compliant with a signed contract, such as in the pain management service, However, some occurrences may be so egregious as to necessitate termination from the entire practice. For example, sentinel events such as violent behavior, abusive verbal behavior, or sexual improprieties. References 1. New Jersey Board of Medical Examiners Law 13:35-6.22. Available at http://www.njconsumeraffairs.gov/laws/bme_regs.pdf. Accessed 2/24/12. 2. American Medical Association Ethical Opinion No. 8.115. Available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/codemedical-ethics/opinion8115.page. Accessed 2/24/12. 2

3. Lippman, H L & Davenport, J. Patient dismissal: The right way to do it. The Journal of Family Practice: March 2011. Volume 60, No. 03: 135-140Nisselle, P. Difficult doctor-patient relationships. The Royal Australian College of General Practitioners. 29(1) January 2000. 4. Thompson, D & Ciechanowski, P. Attaching a New Understanding to the Patient- Physician Relationship in Family Practice. JABFP: May-June 2003 Vol. 16. No 3: 219-224. 5. Stokes, T, Dixon-Woods, M, et al. Ending the doctor-patient relationship in general practice: a proposed model. Family Practice Vol. 21, No. 5: 507-514. 3

Appendix C: Terminate Patient from Rutgers RWJMG (Entire Practice) Date: (Note: Termination date stated below in the body of the letter must be 30 days + 2 days for mail delivery from the date of the letter) Patient name: Date of Birth: Address: City/State/Zip Code: Dear [Insert Patient Name]: This letter is to notify you that the Rutgers Robert Wood Johnson Medical Group is terminating all Patient- Provider relationship. No Provider in the Group will provide care to you after [insert termination month/day/year], thirty (30) days from the delivery of this notice. As required by law, we will provide to you all necessary emergency care or emergency services, including the provision of necessary prescriptions, until the termination date noted above. Emergency care or emergency services means medical care or services required in circumstances where your life or health may be threatened or compromised unless timely medical care is provided. Please know that in the event such emergency care is required, it shall not imply that our Patient-Provider relationship been re-established. [Note: If patient has a scheduled upcoming appointment, please insert the following statement.] Please note that I have canceled your appointment with [Insert Provider Name] on [Insert Date] at [Insert Time]. Finally, I will provide a copy of your professional treatment record and/or billing records, as may be requested, within thirty (30) days from my receipt of a written request from you or your authorized representative, and as required by law. Please contact [insert the name and phone number of the person] to request medical/billing records. Sincerely, [Insert the name, title, and signature of person sending letter]. [Send by regular mail and by certified mail, Return Receipt Requested]

Appendix B: Terminate Patient from a Department/Division Date: (Note: Termination date stated below in the body of the letter must be 30 days + 2 days for mail delivery from the date of the letter) Patient name: Date of Birth: Address: City/State/Zip Code: Dear [Insert Patient Name]: This letter is to notify you that the [Insert Name of Department or Division] of the Rutgers Robert Wood Johnson Medical Group is terminating our Patient-Provider relationship. No Provider in the [insert Name of Department or Division] will provide care to you after [insert termination month/day/year], thirty (30) days from the delivery of this notice. As required by law, we will provide to you all necessary emergency care or emergency services, including the provision of necessary prescriptions, until the termination date noted above. Emergency care or emergency services means medical care or services required in circumstances where your life or health may be threatened or compromised unless timely medical care is provided. Please know that in the event such emergency care is required, it shall not imply that our Patient-Provider relationship been re-established. [Note: If patient has a scheduled upcoming appointment, please insert the following statement.] Please note that I have canceled your appointment with [Insert Provider Name] on [Insert Date] at [Insert Time]. Finally, I will provide a copy of your professional treatment record and/or billing records, as may be requested, within thirty (30) days from my receipt of a written request from you or your authorized representative, and as required by law. Please contact [insert the name and phone number of the person] to request medical/billing records. Sincerely, [Insert the name, title, and signature of person sending letter]. [Send by regular mail and by certified mail, Return Receipt Requested]

Appendix A: Terminate Patient from Individual Provider Date: (Note: Termination date stated below in the body of the letter must be 30 days + 2 days for mail delivery from the date of the letter) Patient name: Date of Birth: Address: City/State/Zip Code: Dear [Insert Patient Name]: This letter is to notify you that I am terminating our Patient-Provider relationship. I will no longer provide care to you after [insert termination month/day/year], thirty (30) days from the delivery of this notice. As required by law, I will provide to you all necessary emergency care or emergency services, including the provision of necessary prescriptions, until the termination date noted above. Emergency care or emergency services means medical care or services required in circumstances where your life or health may be threatened or compromised unless timely medical care is provided. Please know that in the event such emergency care is required, it shall not imply that our Patient-Provider relationship been re-established. [If patient has a scheduled upcoming appointment] Please note that we have canceled your appointment with me on [Insert Date] at [Insert Time]. Finally, I will provide a copy of your professional treatment record and/or billing records, as may be requested, within thirty (30) days from my receipt of a written request from you or your authorized representative, and as required by law. Please contact [insert the name and phone number of the person] to request medical/billing records. Sincerely, [Type in Provider Name and Credentials, and obtain Provider signature above typewritten name] Send by regular mail and by certified mail, Return Receipt Requested