Can A Doctor Refuse To Provide Future Medical Services
To A Patient That Has Filed Bankruptcy And
Discharged A Debt Owed To The Doctor?
Many people file bankruptcy to help deal with medical debts. With the entry of the bankruptcy debt “Discharge Order”, the debtor’s liability for the medical debt is no more. With the entry of the bankruptcy Discharge Order, a doctor forever loses the right to pursue a debtor for payment for unpaid services. (Note: The doctor can still seek payment from any existing insurance policies in place.)
General Rule: The Doctor May Terminate The Relationship If Done Correctly
As a general rule, a doctor may terminate the doctor-patient relationship and refuse to provide future services for reasons including non-payment of a debt as long as termination of the relationship is accomplished correctly. A doctor terminating the doctor-patient relationship without a plan of care for the future can have legal and ethical repercussions including charges of abandonment if not done correctly.
In Washington the general rule for terminating the doctor-patient relationship was set out by the Washington Supreme court in 1942:
It is the general rule that when a physician undertakes to treat a patient, it is his duty to continue to devote his best attention to the case until either medical attention is no longer needed, he is discharged by the patient, or he has given the patient reasonable notice of his intention to cease to treat the patient, so that another physician may be obtained.
Gray v. Davidson, 15 Wash.2d 257, 266-67 (1942).
As a result, under Washington law, a doctor must continue to provide services after bankruptcy, even if a past due bill is not paid, unless/until:
- The doctor provides notice of the intent to withdraw/terminate services that gives the patient sufficient time to find another doctor to continue treatment/services. (Thirty days written notice seems to be the normal approach.)
- The doctor did not initially agree to provide continued or follow up treatment, i.e., the doctor only agreed to treat the patient once or at a certain time or place.
- The patient’s condition does not require continued care
- The patient terminates the relationship (oral or written notice will work)
As an aside, it is worth noting that the American Medical Association (AMA) is of the same opinion on this subject. The AMA FAQ on this question states the following:
The general AMA policy on billing is Opinion 6.05, “Fees for Medical Services.” This Opinion does not specifically address whether a physician might refuse to see a patient due to an unpaid bill. However, Opinion 8.11, “Neglect of Patient” states, “Once having undertaken a case, the physician should not neglect the patient.” Refusing to see a patient might be considered neglect, unless the physician appropriately terminated the patient-physician relationship. Opinion 8.115, “Termination of the Patient-Physician Relationship” states that the physician should provide “notice to the patient, the relatives, or responsible friends sufficiently long in advance of withdrawal to permit another medical attendant to be secured.”
In addition, there may be specific regulations in your state that pertain to unpaid bills or the termination of the patient-physician relationship. You should contact your state licensing board or medical society to find out what the regulations are in your state. Contact information of the licensing boards in all 50 states.
So, yes, a doctor may terminate the doctor-patient relationship and refuse to provide future services where the patient has filed bankruptcy and not otherwise paid a debt. The exception to this would be where the patient-debtor had a plan for ongoing care and the doctor has not provided advance notice to the patient-debtor of termination of the doctor-patient relationship.
Special Exception: Emergency Services Cannot Be Denied
A doctor cannot refuse services to a debtor-patient for a true medical emergency. For example, if you are in an auto accident and you are taken to the emergency room, they must treat you. This rule normally comes into plan only for doctors at hospitals with emergency rooms. See,Emergency Medical Treatment And Active Labor Act.
The Practical Result: Will The Doctor Refuse Future Services?
Just because a doctor can refuse future services, it does not mean he/she will refuse future services. In researching this subject, I reviewed several medical publications. Most of them share the opinion that even if the doctor sustained a significant financial loss due to the bankruptcy filing, the doctor might choose to continue seeing the patient-debtor if they have been with the practice for a long while and have otherwise paid for past services. In short, it might be a smart business decision for the doctor to continue providing future services. (See, article 1, article 2)
Can You Pay The Doctor After Your Bankruptcy Completes?
Many clients want to pay their doctor after bankruptcy discharge to ensure that the doctor continues to provide services. While this may not be required by the doctor for future services, a debtor is free to voluntarily pay on a discharged medical debt.
Free Initial Consultation
If you have any questions about this or any other subject in bankruptcy, please feel free to contact us and set up a free initial consultation. We’ll be happy to help!