Dismissing patients from your practice

One of the most frequent calls we get on our Hotline at Pride Institute is the dentist or team member asking when and how to dismiss a patient from the practice. There is usually a long story involved and lots of confusion.

Typically, they have waited far too long to take this action and have endured a lot of stress as a result. True, it can be uncomfortable. And true, it is easier to hope the patient just goes away. But that rarely happens.

Dismissal protocol

To formally dismiss a patient from the practice, a letter must be written. Keep it short, simple and to the point using these components.

Why the patient is being dismissed: “We have been unable to establish a commitment from you to complete your diagnosed and recommended restorative care. We have determined that our philosophy of comprehensive oral healthcare is not a match for what you want.”

When the dismissal is final: “We will cover any emergency care that you need for the next 30 days to give you time to find another dentist.” Check your state laws. The amount of time varies from state to state.

What you will do: “We will transfer your films and any other information your new dentist requests.”

Closing statement: “We sincerely hope you will find a dentist who matches your philosophy of oral healthcare. We wish you well.”

Make sure a copy of the letter is made for the patient’s paper or virtual chart. Calendar in when to inactivate the patient’s records. Don’t do this until after the time period for the patient to engage another dentist has expired. 

Financial loose ends

The patient being dismissed could have an outstanding account balance or a delinquent account balance. This is a separate issue and should not be part of the dismissal letter.

Some offices prefer to turn delinquent accounts over to a third party for collection rather than sending dismissal letters. This often influences patients not to return. However, these patients will sometimes call for appointments, usually for emergency care, even though their accounts are no longer in the office.
This can be tricky territory. Make sure the practice is in compliance with state laws when deciding if you can tell the patient that the total cost of the delinquent balance plus the estimated cost of their emergency visit must be covered before being treated.

If the patient has not been formally dismissed from your care, you may be obligated to treat him or her even though the account is in arrears. It is important to check with your malpractice insurance carrier on this matter as well.

Preventing dismissals

Examine your protocol and verbal skills regarding new patients. If the time and effort is taken to explain your philosophy of oral healthcare as well as appointment, financial and insurance guidelines starting with the new patient’s first phone call, you can prevent future misunderstandings.

The next step is verbally reinforcing these guidelines during the check-out process after the first appointment. It’s easy to just hand the patient your practice brochure or written financial policy, but materials must be accompanied by a verbal explanation, such as, “So that you can be clear about the guidelines of our practice, I’m going to review some important information with you and take time to answer any questions you may have.”

These steps will save you time and stress and may start a potentially less-than-ideal patient on the right path. If a mismatch is identified and addressed early on, stress can be eliminated for both the patient and the practice by formally dismissing the patient from your practice sooner rather than later.

About the author

Callie Haynes has more than 30 years of experience in dental practice management. Callie’s extensive experience in a wide variety of roles in the dental office enables her to understand the challenges that a practice may face. She specializes in relationship building with patients and teams, customer service and systems implementation. Callie can be at callieh@prideinstitute.com.