This Statement of Philosophy is offered as guidance for medical, osteopathic, and podiatric physicians, physician assistants, and acupuncturists.
The provider-patient relationship is established when the physician, physician assistant, or acupuncturist conducts an evaluation or consultation or otherwise offers to prescribe, diagnose, or treat the patient's complaint(s). This relationship may be ended informally or formally when the patient's problem is resolved; it may also be ended by mutual agreement when the patient transfers their care to another provider.
The provider-patient relationship also may be terminated by either party. For example, the patient may simply leave the licensee's practice or may request a transfer of their records to another provider with or without a more formal notification. Likewise, the licensee may end the provider-patient relationship due to changes in the licensee's scope of practice, practice location, retirement, illness, or other life events.
When a licensee terminates the provider-patient relationship, the licensee must provide appropriate written notice to the patient or the patient's representative sufficiently far in advance (at least 30 days) to allow other medical care to be secured. The written notification should indicate resources that might assist the patient in establishing care with a new provider; however, the discharging licensee is not required to refer the patient to a specific provider or practice. The licensee must ensure that the patient has access to their medical records, and the notice should instruct the patient on how to obtain or transfer those records to their new health care provider. When possible, the letter to the patient and/or to the patient's responsible party should include the reason for ending the provider-patient relationship, but the decision to provide or not provide that explanation is up to the licensee and may be dependent upon the situation.
A 30-day notice may not be possible or practicable in all situations. For example, for some specialties or practice locations (e.g. rural settings), other appropriate providers may not be readily available. Therefore, a longer notification period may be necessary. For patients who are significantly disruptive, threatening, or considered dangerous for the provider or their staff, a much shorter notification period down to and including one day may be appropriate.
In all cases, OMB licensees should approach ending the provider-patient relationship with professionalism and respect for the patient's wellbeing
– Adopted July 2008
– Amended October 6, 2022
The Oregon Medical Board holds licensees to recognized standards of ethics of the medical profession, specifically for this philosophy: American Medical Association's Code of Medical Ethics: Opinion 1.1.5 Terminating a Patient-Physician Relationship; American Association of Physician Assistants' Guidelines for Ethical Conduct for the PA Profession: Initiation and Discontinuation of Care; and Oregon Association of Acupuncturists' Code of Ethics: 1.10 Termination of Practice.
ORS 677.190(1)(a) and ORS 677.188(4)(a)