FEDERAL CRIMINAL LAWYERS

Should I Be Concerned About Patient Abandonment?

You terminated a patient relationship. Maybe you gave notice, maybe you didn’t. Maybe there was an emergency, maybe there wasn’t. Either way, something happened – and now you’re on this page trying to figure out if you should be worried.

Welcome to Spodek Law Group. Our goal is to give you real information about patient abandonment claims – not the sanitized version you find on hospital compliance websites. We’re going to tell you what actually happens when these allegations surface, what the real risks are, and what most doctors get completely wrong about protecting themselves.

Heres the uncomfortable truth that nobody wants to say out loud: the patient abandonment claim itself is rarely the thing that destroys your career. The investigation is. The process is. The two to five years of professional limbo while a medical board decides whether to believe your side of the story – thats what ends careers. And by the time most healthcare providers realize this, the damage is already done.

The Phone Call That Changes Everything

Picture this. Your practicing medicine like you have for fifteen years. Then one afternoon your office manager hands you a certified letter from the state medical board. A patient has filed a complaint. They’re alleging you abandoned them.

You dont even remember this patient. Maybe it was a scheduling conflict. Maybe they no-showed three appointments and you assumed they found another provider. Maybe you DID send a termination letter but they claim they never recieved it. Doesn’t matter. The complaint is now part of your permanant record.

Most doctors assume these alegations get dismissed quickly. They assume the board will look at the facts, realize the complaint is baseless, and close the file. Thats not how it works. Medical boards have manditory investigation protocols. Every complaint – no matter how frivolous – triggers the same beauracratic process. The board has to interview witnesses. They have to review medical records. They have to give you an oportunity to respond. And all of this takes time. Alot of time.

Heres the kicker – before the board has investigated a single fact, before anyone has determined if you did anything wrong, your professional life starts falling apart. Your hospital privileges get put “under review.” Your malpractice insurance company wants to “discuss your coverage.” Every credentialing application for the next decade will ask: “Have you ever been the subject of a medical board investigation?”

Let that sink in. You havent been found guilty of anything. The complaint might be completly baseless. But the cascade has already started.

The investigation takes two to five years. During that time, you cant get hired anywhere that requires board certification. Your insurance rates spike. Other physicians dont want to associate with someone “under investigation.” And when the board finally dismisses the complaint – which happens more often then you’d think – nobody sends out a press release announcing your innocence. The damage is permanant.

This is why you should be concerned about patient abandonment. Not becuase of the lawsuit. Because of everything that happens before anyone determines if you did anything wrong.

What Abandonment Actually Means Under The Law

Most healthcare providers think they understand patient abandonment. They’re usually wrong.

The legal definition sounds simple: abandonment occurs when a healthcare provider unilaterally terminates a patient relationship without giving the patient adequate time and opportunity to find alternative care. Simple, right?

But heres were it gets complicated. Courts dont care what you INTENDED to do. They care what a reasonable patient would PERCEIVE.

You might have sent three termination letters. You might have documented every phone call. You might have given six months notice instead of the standard thirty days. None of that matters if the patient reasonably believed you abandoned them in the middle of treatment.

Think about what that means. Your internal documentation – the notes you wrote to protect yourself – becomes irrelevant if the patients perception tells a different story. And guess whose perception the board is going to credit when your facing a complaint?

The legal elements of abandonment are straightforward:

1. A physician-patient relationship existed
2. The physician unilaterally terminated that relationship
3. The termination occurred without reasonable notice
4. The patient suffered harm as a result

Each of these elements has legal nuances that matter. The first element – the existance of a physician-patient relationship – sounds obvious, but its actualy contested more often then you’d think. Did a brief phone consultation create a relationship? What about a curbside consult with another physician? What about a patient you saw once in the emergency room but never followed up with? Courts have ruled different ways on all of these senarios.

The second element matters becuase of WHO terminated the relationship. If the patient stopped showing up, stopped returning calls, and basicly dissapeared for six months – did YOU terminate, or did THEY? This distinction is critical. Patient-initiated terminations arent abandonment. But proving the patient initiated the break often requires documentation you dont have.

That last element – harm – is were things get interesting. And we’ll talk about that in a minute. But first, you need to understand why focusing on the lawsuit is focusing on the wrong thing entirely.

The Investigation Is The Punishment

Todd Spodek has handled cases like this for years, and he tells every client the same thing: stop worrying about the lawsuit. Start worrying about the investigation.

Heres the thing about patient abandonment lawsuits – they’re actualy incredibly hard to win. The plaintiff has to prove that your abandonment CAUSED their harm. Not that they were harmed. Not that you terminated them. They have to prove the causal connection between YOUR action and THEIR injury.

This is nearly impossible. The patient was already sick when you terminated them. Whatever happened to them after – their condition worsening, a hospital admission, even death – would that have happened anyway? In most cases, yes. And proving otherwise is a causation nightmare for plaintiff attorneys.

An EMS attorney with forty-five years of experience recently said publicly that he has never been involved in a successful patient abandonment tort case. Not once in nearly half a century of practice. Thats how hard these cases are to win.

Let that really sink in. Forty-five years. Probly hundreds of cases. And not a single successfull patient abandonment verdict. The tort system – whatever its flaws – actualy does a decent job of filtering out these claims. The causation burden is simply to high.

So why are doctors terrified of abandonment claims?

Because the lawsuit isnt the real threat. The medical board is.

And heres were most doctors make there biggest mistake. They hire a malpractice defense attorney to handle the lawsuit – someone whos very good at civil litigation – but they dont realize that person probly has no experiance with medical board proceedings. These are completly different forums with completly different rules. What works in civil court can absolutly backfire at the board.

Medical board complaints dont require injury. They dont require proof. They dont require a single verified fact. Someone files a complaint, and the board investigates. Period.

During that investigation, you have almost no rights. You cant confront your accuser in most states. You cant demand a speedy resolution. You cant force the board to show you all the evidence their considering. And you definately cant stop them from suspending your license while the investigation is “pending.”

The investigation IS the punishment. By the time its over, even if you win, your career may already be destroyed.

At Spodek Law Group, we see this pattern constantly. Doctors who could have fought the original complaint – who had perfect documentation, legitimate medical reasons, thirty-day termination letters – destroyed because they didnt take the board investigation seriously from day one.

How These Cases Actually Start

Heres something that will probly surprise you: most patient abandonment allegations dont come from intentional terminations.

Doctors imagine abandonment claims coming from the difficult patient they fired. The drug-seeker they cut off. The non-compliant diabetic who threatened them. Those situations do generate complaints. But their not were most cases originate.

Most abandonment claims come from inadvertent abandonment. The gaps in your system you didn’t even know existed.

Consider these scenarios:

The unreturned phone call. A patient calls your office with concerning symptoms. Your staff takes a message. The message gets lost. Three days later the patient is in the emergency room. They tell the ER doctor they “tried to reach their physician but no one called back.” Now theres documentation – in their hospital chart – that you abandoned them.

The coverage confusion. Your going on vacation. You tell patients to contact Dr. Smith for emergencies. But you never actualy confirmed Dr. Smith agreed to cover. Or you confirmed verbally but never put it in writing. A patient calls Dr. Smith’s office, they have no record of the arrangement, and the patient goes untreated.

The scheduling gap. You gave proper thirty-day notice. But your in a specialty with six-month wait times. The patient cant find another provider in thirty days. They need medication refills, their condition worsens, and they file a complaint alleging you knew adequate care wasnt available when you terminated them.

The missed handoff. Your leaving a practice. You assume the practice is notifying your patients. The practice assumes your notifying them. Nobody notifies them. Patients show up for appointments and discover their physician is gone.

The referral that didnt happen. You refer a patient to a specialist. You assume the specialist will schedule them. The specialist never recieves the referral. Three months later the patient’s condition has worsened dramaticaly, and they file a complaint saying you never arranged the follow-up care you promised.

The after-hours gap. Your answering service takes a call from a patient in distress. The service is supposd to page you, but theres a technical problem. The patient ends up in the emergency room. The ER notes document that the patient “could not reach their physician.”

None of these involve a doctor intentionaly abandoning a patient. All of them can support an abandonment claim.

This is what I mean when I say the system has gaps your not seeing. Your focused on sending the perfect termination letter. Meanwhile, theres an unreturned phone message sitting on someones desk that could end your career.

The Causation Shield

OK so we’ve established that the investigation is the real threat, and that inadvertent abandonent creates most claims. But theres something else you should understand – something that might actualy make you feel better.

As a legal matter, successful patient abandonment claims are extraordinarily rare.

Remember that fourth element? “The patient suffered harm as a result.” This is were plaintiff cases go to die.

To win an abandonment claim, the patient has to prove that YOUR termination CAUSED their harm. Not that harm occurred after you terminated them. That your termination – specifically – was the cause.

Think about what that requires. The patient was already sick. They already had a medical condition serious enough to be under your care. If they got worse after you terminated them, the defense is obvious: they would have gotten worse anyway. The underlying condition caused the harm, not your termination.

This is a causation nightmare for plaintiffs. Their essentially arguing that if you had continued treating them, the outcome would have been different. But how do they prove that? Medical conditions progress. Treatments fail. Patients dont comply. Proving that continued treatment would have changed the outcome is almost impossible.

This is why that EMS attorney hasnt seen a successful abandonment tort in forty-five years. The causation burden is nearly unsurmountable.

But – and this is critical – the medical board doesnt care about causation.

The board isnt deciding whether you owe the patient money. Their deciding whether your fit to practice medicine. And their standard isnt “did this cause harm” – its “does this conduct reflect poorly on the profession.”

You can be cleared of liability in civil court and still lose your license. You can prove the patient would have suffered the same outcome regardless – and the board can still discipline you for “failure to properly terminate the relationship.”

This is the paradox at the center of patient abandonment. The legal claim is weak. The regulatory threat is severe. And most doctors have it exactly backwards.

The Documentation Double-Edge

Now heres were things get really complicated. Because the documentation thats supposed to protect you? It can destroy you.

When you terminate a difficult patient, best practices say to document everything. Document the behavioral issues. Document the non-compliance. Document the missed appointments, the threatening language, the drug-seeking behavior. Put it all in the chart so you have a record of why termination was justified.

But think about what that documentation says to a medical board reviewer.

“This doctor knew the patient was struggling. Knew they were non-compliant. Knew they might have mental health issues or substance problems. And terminated them anyway.”

The same documentation that protects you in court condemns you at the board. In court, it shows your termination was justified. At the board, it shows you knew the patient was vulnerable and cut them off anyway.

This is the documentation paradox. Document to little and you cant prove your termination was proper. Document to much and you prove you knew the patient needed help when you abandoned them.

The timing of documentation matters to. Notes written immediatly after the termination look defensive. Notes written months later – after the complaint – look fabricated. And if theres any inconsistancy between what you documented and what you remember, the board will assume your lying.

Ive seen doctors with perfect documentation lose there cases becuase a single chart note was dated wrong. The board assumed they backdated records to cover there tracks. It wasnt true – it was a clerical error – but once that suspicion takes hold, everything else looks suspect.

Todd Spodek has seen this exact situation play out dozens of times. Doctors who did everything right – proper notice, detailed documentation, legitimate medical reasons – destroyed because their own charts made them look callous or, worse, dishonest.

The solution isnt less documentation. The solution is understanding that documentation serves multiple audiences, and thinking carefully about how each audience will interpret what your writing.

Thats not something most compliance training covers. And its definately not something you figure out after the complaint has already been filed.

What Spodek Law Group Does Differently

If your reading this article, one of two things is happening. Either your considering terminating a patient and want to know the risks. Or something has already happened and your trying to figure out how worried you should be.

Either way, heres what you need to understand: Spodek Law Group approaches these cases differently than most firms.

Most healthcare attorneys focus on the lawsuit. They think about liability, damages, causation defenses. All important stuff. But if your only focus is winning the lawsuit, your missing the bigger picture.

We focus on the board investigation from day one. Because thats were careers are actualy destroyed. Thats were the real consequences happen. The lawsuit might take five years and end with a defense verdict. But by then, if you havent been managing the board situation, it doesnt matter.

Our approach involves three things:

Immediate assessment. Not “lets wait and see what happens.” Immediate analysis of what documentation exists, what the patient is likely claiming, and what the board investigation will probably focus on. We’ve handled enough of these to know what boards look for.

Parallel strategy. Your civil defense and your board defense have to work together. What you say in a deposition affects your board case. What you admit to the board affects your civil case. Most firms dont think about this. We do.

Proactive positioning. Waiting for the board to contact you is a mistake. Sometimes the right move is getting ahead of the complaint – showing the board your documentation, your termination process, your follow-up care before they ask. Sometimes its the opposite. Knowing which approach to take requires experience with how these boards actually operate.

If your worried about patient abandonment – whether something already happened or your planning a termination – call Spodek Law Group at 212-300-5196. We offer confidential consultations specifically for healthcare providers facing these situations.

We put this information on our website because most doctors have no idea how this actualy works. They focus on the wrong threats. They dont understand the investigation process. They dont realize that the documentation protecting them legally might be destroying them professionally.

Now you know. The question is what your going to do about it.

The patients who file abandonment complaints arent thinking about causation burdens or legal elements. Their thinking about how they felt when their doctor disappeared. And thats the perception that drives everything – the complaint, the investigation, the potential destruction of everything you’ve built.

Dont wait until that phone call comes. Get ahead of it. Call us at 212-300-5196. Because the worst time to start thinking about patient abandonment is after someone’s already accused you of it.