# "Patient Abandonment", the law, and refusal to refill prescriptions **URL:** \ **Category:** In My Humble Opinion\ **Created:** [April 2, 2012, 8:52am UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557 "2012-04-02T08:52:06Z")\ **Posts on this page:** 14\ **Page:** 4
**Author:** ![ambushed](https://avatars.discourse-cdn.com/v4/letter/a/3bc359/32.png) [@ambushed](https://boards.straightdope.com/u/ambushed)\ **Post date:** [April 7, 2012, 5:46pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/62 "2012-04-07T17:46:48Z")
> [@amanset](#): > > > [@LurkerInNJ](#): > > > > Shouldn’t you be spending your time and energy finding another doctor asap rather than wasting time splitting hairs about your old doctor’s office? > > > > > [@ambushed](#): > > > > > > Shouldn’t you be reading the thread far more carefully rather than making up crap to insult me with? > > I get that this is stressful for you, but not only was there nothing insulting in the post that you quoted but it was also very good advice… I’d remix that question for you. Do you really want a medical practice that doesn’t want you as a patient? > > Honestly, moving elsewhere really sounds like the best option. _sigh_ Look, the reason I was justifiably annoyed by **LurkerInNJ** ’s and similar posts (including yours) is because I’d already stated several times \*\* – including right there in my OP – that I’m ALREADY SEEKING A NEW DOCTOR!\*\* That’s why I replied “Shouldn’t you be reading the thread far more carefully?” For another example, in [this post](http://boards.straightdope.com/sdmb/showpost.php?p=14933068&postcount=42), I had already written: > [@ambushed](#): > > … Yesterday (Tuesday), I made an appointment with what I dearly hope to be my new, very well-educated, compassion-award-winning doctor (it’s a meet and greet so that I can be assured she doesn’t have any reluctance to care for me in advance), but she’s out of town for the next ten days or so… How many times did I need to repeat that for the benefit of those who couldn’t be bothered to read the thread? ---
**Author:** ![ambushed](https://avatars.discourse-cdn.com/v4/letter/a/3bc359/32.png) [@ambushed](https://boards.straightdope.com/u/ambushed)\ **Post date:** [April 7, 2012, 5:49pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/63 "2012-04-07T17:49:31Z")
> [@lavenderviolet](#): > > I don’t really see a lot of sense in making a big “mission” out of fighting back against this medical practice, when you could use that effort to seek out a doctor who you like and who also wants to see you… And now another one! See [here](http://boards.straightdope.com/sdmb/showpost.php?p=14943345&postcount=62) Sheesh. ---
**Author:** ![ambushed](https://avatars.discourse-cdn.com/v4/letter/a/3bc359/32.png) [@ambushed](https://boards.straightdope.com/u/ambushed)\ **Post date:** [April 7, 2012, 5:53pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/64 "2012-04-07T17:53:06Z")
> [@Shodan](#): > > Bolding added. > > I don’t see what the practice did wrong, legally. You got two copies of the letter and spoke to the office manager, who confirmed exactly what the letters said. The fact that the letter is signed by the whole practice, in effect, I don’t believe is meaningful. The doctor who would have terminated you is dead, if I understand your OP. He cannot sign the letter, therefore, so the letter came from the whole practice. IANAL, but I doubt you have much of a case. Nor do I see what you want to accomplish with your “everything short of a lawsuit”. If you did want to convince us, your posts to this thread, and your description of your actions, are not a good start. I don’t think it matters. You got it via registered mail, and you told the office manager specifically that you received it. And again, I doubt that the letter being signed on behalf of the whole practice is going to make any difference. > > Regards, > Shodan _sigh_ Your premise that “an unsigned letter = everyone signed it” is silly. The truth is that “an unsigned letter = no letter at all”. ---
**Author:** ![ambushed](https://avatars.discourse-cdn.com/v4/letter/a/3bc359/32.png) [@ambushed](https://boards.straightdope.com/u/ambushed)\ **Post date:** [April 7, 2012, 5:56pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/65 "2012-04-07T17:56:55Z")
> [@Foxy40](#): > > I have no idea why you keep insisting this is illegal. I seems you want it so bad to be true that you’re confusing possible unethical with illegal. There isn’t a physician in this country that has to treat you for a routine follow up. They have discharged you. They have offered to treat you within the 30 days in the event of an emergency. The only problems regarding the prescription refills I can see is if the medications are something that 1. Could cause you withdrawal symptoms 2. You need them to remain healthy. > > Spend your money on a lawyer site. They will tell you the exact same thing. There is no law against discharging a patient in no imminent danger whether the notification is an unsigned letter or carrier pigeon. Liability issues, perhaps if something happens to you, illegal, no. > > You haven’t said what they are for. I could be wrong and maybe giving the doctor’s office a knee jerk benefit of the doubt but I suspect they are quality of life medication and not medically necessary. I _did_, in fact, explain what they are for! Diabetes and high blood pressure, among others. These are not “quality of life” issues, they’re very serious. Why won’t anyone read? ---
**Author:** ![ambushed](https://avatars.discourse-cdn.com/v4/letter/a/3bc359/32.png) [@ambushed](https://boards.straightdope.com/u/ambushed)\ **Post date:** [April 7, 2012, 7:12pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/66 "2012-04-07T19:12:54Z")
Instead of a serious effort to provide solid answers with citations for my two General Questions (which I hold to be partially **samclem’s** fault for moving this thread from General Questions into an “opinion” forum), it has since turned into yet another case of “criticize the OP”. Thus, I’m departing the thread. However, my considerable gratitude goes out to **IvoryTowerDenizen**. The following is from several documents regarding patient termination / abandonment / negligence / ethics that continue to very much persuade me that those who’ve been criticizing me are off base and that the office did indeed mistreat me: > [@](#): > > "Physicians take an oath to always act in the best interest of their patients, and they are expected to abide by it. In fact, doctors, unlike patients, face legal and ethical restrictions before they may end relationships with patients. > > … any attempt by the doctor to sever the doctor-patient relationship is a tricky undertaking… the relationship between a doctor and a patient is clearly considered to be different… > > How can a doctor fire me?.. > > **Proper documentation is essential. A doctor’s dismissal of a patient can be appropriate if there are multiple well-documented and clearly understood attempts by the doctor to discuss the issue with the patient, as well as attempts to rectify the situation.** Many doctors’ offices have a protocol for discharging a patient (even though it usually occurs very infrequently). **The doctor should make a full effort to explain his/her concern to the patient and document each such attempt.** The attempts must be in clear, non-medical terms, so that the patient understands the issues. Yet nothing like that took place! > [@](#): > > “Physicians may withdraw from a case **so long as doing so does not violate ethical or legal requirements and does not disrupt a patient’s continuity of medical care.** Prior to termination, special considerations should be flagged (e.g., protections afforded under the Americans with Disabilities Act and Board of Registration in Medicine regulations, limitations in third-party payer contracts, and conditions unique to the physician’s particular specialty).” All that applies in my case, yet nothing like that was done. This termination has most definitely disrupted the continuity of my medical care. The overwhelming majority of the care any American doctor delivers these days is in the form of medications. Refusing to refill them before the 30-day period elapses is unambiguously a disruption of my medical care, and is clearly is an ethical, if not also legal, violation. And I’ve finally found document that does indicate that “continuity of care” includes refilling medications for chronic and other conditions. Thanks to those few who read the thread carefully and made a sincere effort to answer my General Questions! ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [April 7, 2012, 7:32pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/67 "2012-04-07T19:32:25Z")
> [@ambushed](#): > > _sigh_ > > Your premise that “an unsigned letter = everyone signed it” is silly. The truth is that “an unsigned letter = no letter at all”. That’s what the manager told you, as well as what I told you. If you would prefer to ignore everything you don’t want to hear, well, that offers some insight as to why they might not want to keep you as a patient. Regards, Shodan ---
**Author:** ![LurkerInNJ](https://avatars.discourse-cdn.com/v4/letter/l/ed655f/32.png) [@LurkerInNJ](https://boards.straightdope.com/u/LurkerInNJ)\ **Post date:** [April 7, 2012, 7:57pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/68 "2012-04-07T19:57:52Z")
> [@ambushed](#): > > Shouldn’t you be reading the thread far more carefully rather than making up crap to insult me with? Shouldn’t you be out looking for a doctor who wants to deal with you since this practice clearly does not? Oh, wait … it’s that issue with priorities you have going on, right? ---
**Author:** ![LurkerInNJ](https://avatars.discourse-cdn.com/v4/letter/l/ed655f/32.png) [@LurkerInNJ](https://boards.straightdope.com/u/LurkerInNJ)\ **Post date:** [April 7, 2012, 8:13pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/69 "2012-04-07T20:13:16Z")
Looks like the internet lawyers aren’t rallying to his cause either: \*However, from the facts you’ve described, the doctor you treated with passed away. If anyone abandoned a patient, it was him. You had not yet treated with the doctor who sent you the letter. Thus, the doctor who sent you the letter cannot be charged with malpractice or patient abandonment. Technically, you were never his patient. To be sure, the practice said that they would try to find room. However, that is not a legally binding obligation and, in fact, you were later informed that would not happen. Expressing a physician preference does not create a doctor-patient relationship. It’s unfortunate for sure – but it does not violate any laws. You may want to consider obtaining a copy of your medical records and take upon the task of finding a new doctor to treat with.\* ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [April 7, 2012, 10:44pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/70 "2012-04-07T22:44:12Z")
> [@Shodan](#): > > That’s what the manager told you, as well as what I told you. > > If you would prefer to ignore everything you don’t want to hear, well, that offers some insight as to why they might not want to keep you as a patient. > > Regards, > Shodan Accepting their own research on what the law actually says overs someone who admitted that they are not a lawyer and have not done any research on the subject is somehow a character flaw now? Just because someone does not listen to YOU does not make them a bad person. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [April 7, 2012, 10:52pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/71 "2012-04-07T22:52:06Z")
> [@LurkerInNJ](#): > > Shouldn’t you be out looking for a doctor who wants to deal with you since this practice clearly does not? > > Oh, wait … it’s that issue with priorities you have going on, right? Say it with me now: HE ALREADY HAS A NEW DOCTOR! If you aren’t going to read the thread, your opinion on the matter is useless. This board is about fighting ignorance, not using your ignorance to attack people you don’t like. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [April 7, 2012, 11:07pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/72 "2012-04-07T23:07:09Z")
> [@Foxy40](#): > > I think it is as simple as his feelings were hurt and he is trying to get some kind of payback to make himself feel better. > > It is his time and money so if making a mountain out of a molehill with little or no reward helps him, I guess he should go for it. > > However, I am beginning to suspect his discharge had something to do with a personality conflict with the staff. You admitted it was illegal for the doctors not to provide medication in your first post. Now you insult him by saying he won’t accept it isn’t illegal? Why should he listen to you when you contradict yourself in order to insult him? ---
**Author:** ![LurkerInNJ](https://avatars.discourse-cdn.com/v4/letter/l/ed655f/32.png) [@LurkerInNJ](https://boards.straightdope.com/u/LurkerInNJ)\ **Post date:** [April 7, 2012, 11:36pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/73 "2012-04-07T23:36:50Z")
> [@BigT](#): > > If you aren’t going to read the thread, your opinion on the matter is useless. This board is about fighting ignorance, not using your ignorance to attack people you don’t like. I read the thread. Did you read the response from his internet lawyer? This board is about fighting ignorance, not using your ignorance to attack people you don’t like. ---
**Author:** ![LurkerInNJ](https://avatars.discourse-cdn.com/v4/letter/l/ed655f/32.png) [@LurkerInNJ](https://boards.straightdope.com/u/LurkerInNJ)\ **Post date:** [April 7, 2012, 11:40pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/74 "2012-04-07T23:40:13Z")
> [@BigT](#): > > Say it with me now: > > HE ALREADY HAS A NEW DOCTOR! He said he is SEEKING a new doctor. That’s from 11:46 am today. Didn’t you read the thread? ---
**Author:** ![TokyoBayer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tokyobayer/32/13989_2.png) [@TokyoBayer](https://boards.straightdope.com/u/TokyoBayer)\ **Post date:** [April 8, 2012, 12:35pm UTC](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557/75 "2012-04-08T12:35:51Z")
> [@ambushed](#): > > **However** , I’ve learned online that an unsigned letter has no legal effect at all (see [Is an unsigned letter legally binding?](http://wiki.answers.com/Q/Is_an_unsigned_letter_legally_binding) and [A unsigned letter has legal binding no?](http://wiki.answers.com/Q/A_unsigned_letter_has_legal_binding_no)) > > So my first General Question is: Is it actually true in this case that, effectively, its as if the letter doesn’t even exist? Or is it binding all the same? This is not longer the domain of GQ, this is now into legal land, and wiki.answers are not binding in court. We can all speculate to our and your hearts’ delight, _but_ we’re not lawyers specializing in medical matters. If it matters that much to you, then go talk to a malpractice attorney. Here is the quote you are basing your argument on. > [@](#): > > Is an unsigned letter legally binding? > > An unsigned letter is not legally binding. Good luck taking that one to court. Or call the medical board in your state and find out the guidelines. You seem fixated if the letter is signed or not. Only an attorney can tell you if that makes a difference. As others have speculated, and this is all speculation, there could very well be a legal difference between a doctor firing an existing patient and another doctor in a practice practice refusing to accept the patients from a deceased partner. If there is no legal obligation for fellow doctors in a group to accept a deceased doctor’s patients, then it seems likely to that the question if the letter is signed or not is a moot point. > [@ambushed](#): > > By the way, a doctor can much more easily reject a patient with whom he has no history, and I’ve never met the man. However, I have been seen by another doctor in that practice when the now-deceased doctor was unavailable (only later to learn at his funeral service that this unavailability was due to his stage-four cancer). **And it is this second doctor who was sent my refill requests and who has still refused to act on them. Thus, the laws against patient abandonment are in full force and definitely apply in my case.** (my bolding) You state these as if there were facts of law. There could very well be a legal distinction between a doctor covering for someone else and accepting them as their own patient. > [@](#): > > If anyone is interested, here are some links to various documents that discuss patient dismissal and abandonment in the U.S. > [Can your doctor dismiss you from his/her practice – legally?](http://www.oncolink.org/resources/article.cfm?c=3&s=38&ss=201&id=869) > > [Legal Advisor: Terminating the Doctor-Patient Relationships](http://www.massmed.org/Content/NavigationMenu2/ContinuingEducationEvents/NewCourses/TheLegalAdvisorTerminatingtheDoctorPatientRelationship/HowtoTerminatetheDoctorPatientRelationship/How_to_Terminate_the.htm) (Note that this is from Massachusetts, which may have different rules than Michigan. However, I can’t find an equivalent Michigan document) > > [When a physician may refuse to treat a patient](http://www.physiciansnews.com/law/202.html) > > [AMA Code of Medical Ethics: Opinion 8.115 - Termination of the Physician-Patient Relationship](http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion8115.page) (Far too brief to be of much value). > > [When the Patient-Physician Relationship Is Broken](http://virtualmentor.ama-assn.org/2008/09/ccas2-0809.html) None of these involve groups practices, so they may or may not be relevant to your case. > [@](#): > > Anyway, this whole business once again shows that I chose my username well, yes?! Yes, I can see why you feel that way. > [@BigT](#): > > Accepting their own research on what the law actually says overs someone who admitted that they are not a lawyer and have not done any research on the subject is somehow a character flaw now? The research the OP did says nothing of the law in general and nothing specific to this case. [Previous page](https://boards.straightdope.com/t/patient-abandonment-the-law-and-refusal-to-refill-prescriptions/617557.md?page=3)