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Where these qualities are absent or have been undermined, the provision of quality care may be compromised.Examples of situations that may lead to a significant breakdown in the physician-patient relationship include, among others: Except where there is a genuine risk of harm, physicians must only end the physician-patient relationship after reasonable efforts have been made to resolve the situation in the best interest of the patient.

In every case, physicians must bear in mind that ending the physician-patient relationship may have significant consequences for the patient, for example, by limiting their access to care, or by reducing their level of trust in the medical profession.For this reason, physicians must undertake reasonable efforts to resolve the situation affecting their ability to provide care in the best interest of the patient, and only consider ending the physician-patient relationship where those efforts have been unsuccessful.The following examples include situations in which it may be appropriate to end the physician-patient relationship; however, each case is ultimately fact-specific.Physicians must always use their own professional judgment, in keeping with this policy, to determine whether discontinuing the relationship is appropriate.Physicians embody these values and uphold the reputation of the profession by: This policy articulates the College’s expectations of physicians when ending the physician-patient relationship.

These expectations apply equally to all physicians, regardless of specialty or area of practice.

While all physicians are expected to act first and foremost in the best interests of their patients, there may be times when physicians’ ethical and professional obligation to provide care to an individual patient is in conflict with their other important duties or obligations, such as those owed to their other patients, colleagues, or themselves.

In circumstances such as these, physicians may consider ending the physician-patient relationship.

In these circumstances, it may be necessary for the physician to decrease the number of patients to whom care is provided.

As each practice and patient population is unique, physicians must exercise their own professional judgment, consistent with this policy, in selecting which patients to remove from their practice.

Policy Number:#2-17 Policy Category: Practice Under Review: No Approved by Council: February 2000 Publication Date: Dialogue, Issue 2, 2017 Reviewed and Updated: June 2008, May 2017 College Contact: Physician Advisory Service Downloadable Version(s): Ending the Physician-Patient Relationship | Comment mettre fin à la relation médecin-patient An effective physician-patient relationship is essential for the provision of quality medical care, and it forms the foundation of the practice of medicine.