Why did my pain specialist dump me as a patient?

Dear Reader,  

Getting “dumped” by anyone can hurt but ending a relationship with a health care provider may disrupt treatment or impact health. While there are several valid and legal reasons why a provider may dismiss a patient, patients also have rights when it comes to continuity of care, access to medical records, and non-discrimination. These rights can vary between states and countries. If the reasons for your dismissal weren’t made clear to you, you could ask for clarification — both for peace of mind and to transition treatment to another provider.   

Though your question doesn’t mention why your pain specialist removed you as a patient, there are a number of reasons why a provider may send such a letter. In some cases, a health care provider may be retiring, relocating, believe that they don’t have the resources or expertise to meet the patient’s medical needs, or conclude that the patient’s treatment is complete. Providers may also choose to stop seeing a patient if the patient does any of the following:  

• Fails to pay for services  
• Misses scheduled appointments  
• Doesn’t follow the treatment plan, which may include violating substance use policies  
• Behaves inappropriately towards health care provider or staff (such as disruptive, seductive, violent, or threatening actions)  
• Falsifies or provides misleading medical history  

It’s worth mentioning that there are some ethical and legal guidelines for health care providers to consider when ending a relationship with a patient. The American Medical Association (AMA) maintains that health care providers have an ethical responsibility to uphold a patient’s well-being and can’t decline care or discriminate based on factors such as religion, race, gender, sexual orientation, or health condition. In fact, if a health care provider fails to provide reasonable notice or rationale for ending a relationship, it could be considered “patient abandonment,” which could carry legal and medical penalties. To end a patient-health care provider relationship, it’s advised to notify patients (often by letter) about the reasons for terminating the relationship, offer support for transitioning care (either by another provider or at a different practice with the same expertise), and request written approval to send a copy of medical records to the new health care provider. Ample notice from a medical professional can help patients who are high-risk or most likely to suffer adverse health outcomes if there’s a gap in care to transition to a new provider.  

If you’ve been “dumped” as a patient by a health care provider, there are different ways you can proceed if you want to take action. Generally, it’s recommended that you try to first reconcile peacefully and respectfully. If requested, your provider may be willing to explain to you why this decision was made. Some other options you may consider include:  

• Seeking an informal resolution: You could consider speaking with a different health care provider to see if they can take over your care.  
• Asking for or getting a referral: As part of their medical code of ethics, health care providers are obligated to not only give adequate notice of termination in writing, but they may also provide you with referrals, as this is typically considered good practice. You can also be proactive and request that your pain specialist refer you to another health care provider for your pain management.  
• Accessing medical records and transitioning care: Under laws such as the Health Insurance Portability and Accountability Act (HIPAA), a patient has a right to their medical records (no matter the reasons for termination), though there may be a cost associated with mailing the records. Collecting these records can allow a new health care provider to better understand a patient’s medical history and to more smoothly deliver treatment.    
• Filing a complaint with the state medical board: Historically, this option hasn’t had a high rate of success, but patients who are able to provide evidence for emotional or physical consequences of having their relationship with their health care provider terminated may be successful in having sanctions placed against the provider.  
• Suing for abandonment or infliction of severe emotional distress: This option isn’t recommended for all situations of patient dismissal. If you’re interested in pursuing this option, it’s best to consult with a lawyer to see if this strategy is advisable in your situation.  

Whether you seek a resolution with your previous provider or find a new one, hopefully these options can help you find a way to get back on track with managing your pain. No matter what you decide to do next, being on the same page about your treatment and the expectations of both you (as the patient) and your provider (as the medical expert) might be the key to finding reliable pain relief in the future.