Open Bar: Physician Safety – Options for Dealing with Threatening Patients

Question: What options are available to physicians when patients make repeated threats to the physician’s safety and well-being?

Response: A patient presented to an ophthalmologist complaining that his vision had changed. The physician found mites in the patient’s eyelashes, offered to do a deep cleanse in the office and suggested home care. The patient was told that he may be uncomfortable for a few days and that he should lie down with his eyes shut instead of blinking. He made a follow-up appointment for himself, as well as one for his wife and 10-year-old child and left the office seemingly normal.

Over the next few days, the patient started calling the office and threatening the staff. Employees became alarmed when the patient related the physician’s home address and said he was going to be “sending people” to her home and her office. More calls to the office continued, with threats to sue and to personally come after the physician. The patient’s 10-year-old called to cancel the three appointments. The patient took the phone from him and voiced more threats.

The physician told her staff to record the patient’s calls, which they did. The patient continued to make threatening phone calls throughout Friday and Saturday, sent pictures of the physician’s home and referred to her husband by his first name. The physician tried to comfort her staff by telling them how easy it is to get all this information online. The patient started calling the physician’s home number on Sunday, which was Mother’s Day. Her children answered those calls and became very upset hearing the patient threaten to kill their mother and say that he would bury her.

The police were called on that Saturday and Sunday. They heard the recorded messages and listed available options for the physician:

file a police report for an order of protection

hold off for now and go further if the situation escalates

call the patient and advise him to stay away from the physician

have the patient arrested

The physician did not file an order of protection or pursue any other action because she was afraid to incite the patient. She was comforted by the fact that the patient lived far from her home address.

Assistance was provided to the physician in drafting a letter to the patient wherein she terminated her relationship with him and the other two members of his family. The discharge from care letter did not offer availability for emergency care for 30 days, as is commonly done, due to the nature of events that occurred in the days prior. The patient was provided with suggestions to contact the county medical society or a local clinic for continuation of care for the patient and his family. The physician expressed concern about a potential HIPAA violation due to the information she shared with the police, but was reassured that exceptions allow the release of PHI under the given circumstances.

MLMIC policyholders can reach out to our healthcare attorneys for questions about how to handle a threatening patient, including discharge from practice, or any other healthcare law inquiries by calling (877) 426-9555 Monday-Friday, 8 a.m.-6 p.m. or by email here.

Our 24/7 hotline is also available for urgent matters after hours at (877) 426-9555 or by emailing hotline@tmglawny.com.

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This document is for general purposes only and should not be construed as medical or legal advice. This document is not comprehensive and does not cover all possible factual circumstances. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors for any questions related to legal, medical or professional obligations, the applicable state or federal laws or other professional questions.