Often in practice, you may see someone once or they become a regular long-term client/patient. For many practitioners, your clients are a joy to treat and help on their health journey. However, some practitioners have encountered a client/s who they no longer wish to treat and we find that the process of terminating this relationship can be uncomfortable and awkward.
Rest assured, practitioners and clients both have the right to terminate a healthcare relationship at any time, within the Code of Conduct (QLD, NSW, VIC, SA). However, unlike for a client, a practitioner should do so in a professional manner so as not to upset their client or hinder their health journey.
We have put together a list to consider if ever needing to end a professional relationship with a client.
Why do you want to end the relationship?
Firstly, ask yourself why you are wanting to end the relationship to ensure the reason is clear. Often, this is due to scope of practice and the needs of the client exceed the ability of the practitioner and you need to refer them on.
However, there are instances where the practitioner no longer feels safe with the client, and this is also a perfectly acceptable reason to discontinue treating someone.
Be careful not to discriminate
Discrimination is unlawful in Australia and practitioners need to be mindful in how they approach a situation to ensure they are not seen to be discriminating against any particular person. This is more relevant in the sense that you have already started a professional relationship and no longer wish to continue this relationship.
How does the practitioner end the relationship?
Unlike the client deciding a practitioner is no longer suitable and choosing to not return, or requesting a copy of their file and moving on; a practitioner needs to approach this situation with a more professional approach.
The best case scenario would be that the practitioner has determined that the client needs further expertise to resolve the client’s health issue and offers them a referral. This can be done at the end of the consultation in person, which is a professional and polite way of assisting the client to seek the care they require.
In circumstances where the practitioner no longer feels safe to be around their client as they have either shown abusive tendencies, made sexual advances, or have threatened the practitioner or their staff, it is advisable to not have any further face-to-face contact and to keep the communication between the parties in writing.
Whilst a phone conversation can achieve the same goal, terminating the relationship in writing will keep a record of what was said should the situation escalate further.
In these circumstances, we recommend waiting to write the termination email until the emotional situation has subsided. It is always best to maintain professionalism and, where possible, refer the client to another practitioner. It is advised to be clear in the email that you are no longer able to see this client, reasons being outside your scope of training or schedule conflicts, and provide referrals within the email. Let them know you can also assist with passing along their client notes to their next practitioner. You can use your own discernment in the situation whether you wish to convey why you are ceasing the relationship. This may be helpful in some instances, or it could escalate the situation.
Should the client continue responding to emails, it is recommended to cease communication with this person as you have terminated the relationship. Email your association with this information so they have a record of it in your file, should it go further. You may also need to contact your insurer to advise them in the event that client attempts to make a claim against you for any reason.
Document in Client Notes
If something happens with a client which causes a practitioner to want to terminate the relationship, this should be well documented in their client notes. These notes should contain the relevant information for the treatment at a session and go on to outline the events which lead to your decision. Should the client continue their behaviour for a period of time afterwards, keep a record of any communication with this client in their file.
If you or your staff feel unsafe or in danger, contact the police. If you feel like the client is harassing you, you should file a report with the police and discuss with them any action you may be able to take.
Understandably, a situation like this can be very stressful and overwhelming. It is uncommon that these kinds of situations unfold for practitioners, but having a better understanding of your ability to terminate the relationship and how to go about it can help to make these decisions much easier.