Challenging Patient: Should I End the Doctor Patient Relationship

A malpractice defense attorney shares four considerations to be aware of with challenging patients.

Risk Management

Challenging Patient: Should I End the Doctor/Patient Relationship

Question: From time to time, I have patients who are more challenging than others. What is the best way to deal with them and when is it time to end the doctor/patient relationship?


Answer: Malpractice defense attorney Victoria Vance recently shared with NCMIC four things to keep in mind on this matter in the following video.

board complaints video play

In this video, Victoria noted that at some point every Doctor of Chiropractic is apt to come across a patient or a patient’s family member who seems particularly challenging to their practice. Therefore, doctors should be prepared to:

  1. Identify the Patient—It is important to be able to recognize that a patient may be dissatisfied or concerned about a particular issue or aspect of their care and be able to know that they may need additional attention.
  2. Manage the Patient—The second step is to be prepared to actively manage that patient. That means being able to understand that that patient, because of their concerns, may need some additional time for an appointment.You may want to consider scheduling the patient earlier in the morning or at a particular time of the day when you know you can give that patient the time and attention the individual needs.
  3. Communicate with the Patient—Another overriding consideration is to communicate. Patients may have concerns or challenges, and for you to manage your patients and provide them with the best chiropractic treatment,you need to try to understand what their concerns are. It may really have nothing to do with you or the care they are getting in your office. There may be a family issue; there may be a personal issue.
  4. Document the Situation—The fourth consideration for difficult patients is documentation. Take the time to document your records about your interactions and about questions and statements that the patient has made to you. In addition, make sure to document the efforts you made to address their care and the services that you’ve rendered to them.

Is It Time to End the Doctor/Patient Relationship? 

Always keep in mind that there may come a point where you feel you are not able to provide the type of care that your patient needs of you. At this point, consider ending your relationship with your patient. Tell your patient that it may be in his or her best interest to seek care with another practitioner. Look to your board rules for any guidance that is provided in your state for how you best need to communicate the termination of that relationship.


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.