Can a physician terminate a patient-physician (doctor-patient) relationship prior to surgery without providing a reason?

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Last updated: April 6, 2025View editorial policy

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From the Guidelines

A doctor cannot drop a patient before surgery without a valid reason and proper notice, as this could constitute patient abandonment. This principle is rooted in ethical and legal obligations to provide continuity of care once a doctor-patient relationship has been established 1. The guidelines emphasize the importance of early discussions and shared understanding between the patient and healthcare providers, including anaesthetists and surgeons, to ensure that the patient's values, preferences, and wishes are respected and documented 1.

Key considerations in the peri-operative period include:

  • Ensuring the patient has capacity to consent to treatment and that their decisions are informed and voluntary
  • Discussing and documenting the patient's advance care plans, including any do-not-attempt-cardiopulmonary-resuscitation (DNACPR) recommendations
  • Suspending DNACPR recommendations during the peri-operative period, if necessary, with the patient's agreement and explanation to the healthcare team
  • Ensuring the healthcare team is aware of the patient's advance decisions and their legal status

In the context of dropping a patient before surgery, a valid reason might include patient non-compliance with critical pre-operative instructions, development of a conflict of interest, or a breakdown in the doctor-patient relationship that compromises care. However, even in such cases, the doctor must provide reasonable notice and ensure a proper transfer of care to another qualified healthcare provider 1. The protection against patient abandonment is essential to prevent harm to the patient's health, particularly when they are vulnerable and preparing for surgery.

From the Research

Dropping a Patient Before Surgery

  • There is no direct evidence in the provided studies that addresses a doctor's ability to drop a patient before surgery without a reason 2, 3, 4, 5, 6.
  • The studies focus on preoperative care, patient safety, and medical management before surgery, but do not discuss the specifics of a doctor-patient relationship or the circumstances under which a doctor might drop a patient 2, 3.
  • However, it can be inferred that a doctor's decision to drop a patient would likely be influenced by ethical and professional guidelines, as well as legal considerations, rather than being entirely without reason 5.
  • The provided studies do emphasize the importance of communication, collaboration, and patient-centered care in the preoperative period, suggesting that any decision to drop a patient would need to be made with careful consideration of the patient's needs and well-being 2, 3, 4.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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