Discharging a patient you characterize as “disruptive” to your practice may not be the end to the story. Sometimes, these patients will want to be your patient again. Like a repentant child, they may vow to behave differently this time.

Posted in Risk Management on Wednesday, January 9, 2019

Disruptive patients include those who resort to inappropriate language, such as racial or ethnic slurs, or intimidating, demanding language. They also include patients who harass others and/or are loud and disruptive to the practice.

Considering that patient outbursts may be due to stress, health or mental health, or substance abuse issues, what should you do if the dismissed patient asks to return to your care? 

Each situation needs to be addressed independently, based on the circumstances surrounding their dismissal and the egregiousness of their actions. Depending on your location, specialty and the number of other providers in your area, you may believe you need to accommodate the patient.

Consider the following before making this determination:

• Determine which changes the patient has made to make the situation less likely to reoccur (e.g., counseling or substance abuse care)
• Identify if there has been sufficient length between the patient's discharge and his or her request for return to care
• Establish ground rules for future encounters (communication/actions):
  • Meet with the individual and provide the patient with a copy of your patient rights and responsibilities document
  • Verbally go over the patient rights and responsibilities document with the patient/family
  • Identify agreed upon steps to address potential future issues 
• Ask providers and staff members for input on whether to re-accept the patient

If you decide not to take the patient back into care and you have concerns about this potentially touchy situation, please contact us.