Tom on Leadership 2008-05-13 21:39:00

A client had to write a letter to staff about a client that had to be fired. Here’s most of that letter, with my response on how to take best advantage of a bad situation.

Hey there, Team,

S__ has been discharged (fired) from care from [clinic name]. This includes all care rendered by our clinic. She has been continually unwilling to follow the treatment path and has been abusive to the staff in many ways.

The physician (practitioner)-patient relationship is very important and that for reasons we have enumerated to her in the letter, we have been unable to effectively create this relationship and the relationship it is now ineffective.

Following the events of the past days with S__, she called today to ask if she could continue care with M__. As Medical Director, I made the call that she could NOT. She is not seeking care in an appropriate manner, is abusive to the staff, and is undermining her own care with the practitioners.

I spoke with her on the phone tonight (and I will follow up with a letter by certified mail as is customary). She was surprised that I called. I told her that legally she has 30 days following the firing letter to continue care, but we would rather her contact Dr. J__ for an immediate referral to other practitioner(s). Dr. J__ has received a copy of the firing letter and I am sure will cooperate to refer her to another practitioner ASAP.

Her file will be marked, FIRED—DO NOT RECALL—PATIENT REMOVED FROM DATABASE, so that she is not invited into our clinic again.

At this point, we need to put our shoulders together, make a united front and act accordingly.

You’ve written a good letter. Here’s one way you can take it a step further.

Look over your letter and pick out (perhaps with help from someone who writes quickly) the major themes and steps here. What comes to my mind – and all of this belongs in the policy and procedures manual – include:

When does a patient get discharged?

Who decides that this happens?

How is it announced? What details should always be included? What should never be?

What is my role (for each role in the practice – front desk, practitioner, etc.) in supporting this decision? What should I now do, and what should I not do?

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