Disruptive Former Patient Wants to Return

QUESTION: I dismissed a patient who used a racial slur and intimidated one of my staff members. Suffice to say, his behavior was disrespectful and disruptive to the practice. Now he wants to return to care, saying he's changed. What should I do?

Posted in Risk Management on Thursday, October 24, 2019

ANSWER: Considering that the patient’s behavior may have been due to a physical or mental health issue or a substance abuse problem, you may believe you need to accommodate him.

However, it can be beneficial to consider the following before making this determination:

• Find out what changes the patient has made to remedy the situation (e.g., counseling or substance abuse treatment).
• Decide whether there has been a sufficient length of time between the patient’s discharge and his return to care.
• Ask staff members for their perspective on whether to re-accept the patient into the practice.

If you decide to allow the patient to return, make sure you establish ground rules for future encounters. This includes meeting with the person to go over his rights and responsibilities and agreeing upon what will happen if issues reoccur.

It’s not always easy to determine whether to allow a dismissed patient to return to your care. However, each situation needs to be addressed independently, based on the circumstances surrounding the patient’s dismissal and the egregiousness of their actions.

Depending on the circumstances, you may decide to accept them as a patient once again. If you have questions about how to handle this challenging decision, please contact the NCMIC Claims Advice Hotline at 800-242-4052.