Terminating the Physician-Patient Relationship in Office-Based Settings

Category: Physician-Patient Relationship
Under Review: No
Issued by Council: January 1, 2010
Reissued by Council: January 9, 2014


  1. A physician who terminates a relationship with a patient must have reasonable grounds for discharging the patient from his or her medical practice and document those reasons in the patient’s record.
  2. A physician must not discharge a patient:
    1. based on a prohibited ground of discrimination including age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, or socioeconomic status;
    2. because a patient makes poor lifestyle choices (such as smoking);
    3. because a patient fails to keep appointments or pay outstanding fees unless advance notice has been given to the patient;
    4. because the patient refuses to follow medical advice unless the patient is repeatedly non-adherent despite reasonable attempts by the physician to address the non-adherence; or
    5. because the physician relocated his/her practice to a new location/setting to which current patients could be reasonably expected to follow.
  3. Notwithstanding 2 (e), a physician may terminate patient relationships if:
    1. the physician is changing scope of practice wherein current patients would no longer fit within the new scope; or
    2. a relocation occurs more than twelve (12) months after closing an earlier practice.
  4. When unilaterally terminating a relationship with a patient, a physician must:
    1. give advance written notice of intention to terminate care and provide a timeline that is commensurate with the continuing care needs of the patient;
    2. advise the patient of the reasons for termination of the physician patient relationship unless disclosure of the reasons could be expected to:
      1. result in immediate and grave harm to the patient’s mental or physical health or safety;
      2. threaten the mental health and physical health or safety of another individual; or
      3. pose a threat to public safety.
    3. ensure continuity of follow-up care for outstanding investigations and serious medical conditions prior to the termination date or arrange transfer of care to another physician;
    4. provide or arrange for care until the termination of care; and
    5. establish a process for transfer of the patient’s medical information in response to future requests by the patient or an authorized third party.
  5. Notwithstanding subsection (4), a physician may immediately discharge a patient if:
    1. the patient poses a safety risk to office staff, other patients or the physician;
    2. the patient is abusive to the physician, staff or other patients;
    3. the patient fails to respect professional boundaries; or
    4. the physician is leaving medical practice because of personal illness or other urgent circumstances.


The CPSA Standards of Practice are the minimum standards of professional behaviour and ethical conduct expected of all physicians registered in Alberta. Standards of practice are enforceable under the Health Professions Act and will be referenced in the management of complaints and in discipline hearings. About the CPSA Standards of Practice

Contact

For archived standards, policies and guidelines:
Chantelle.Brigden@cpsa.ab.ca