Patient Rights, Professional Communication, and Referral Obligations
Patient rights
Patients have the right to be informed, to consent or refuse, to privacy, to access their records, to be treated with dignity, and to be free from discrimination. That last right carries practical duties: reasonable accommodation for disability under the ADA, effective communication for limited-English-proficiency patients (a qualified interpreter, not a child), and clear fee information before treatment begins.
Communication
Use plain language and teach-back; confirm understanding rather than asking "any questions?" Document informed refusal in the patient's own words. Address complaints openly and record them. Coordinate care so instructions from different providers do not conflict.
Referral obligations
Refer when the needed care is outside your scope, when the condition needs a specialist, or when the patient's needs exceed what the setting can safely provide. Make the referral timely, give the patient the information needed to act on it, and send records with proper authorization. An RDH identifies the need and refers; the dentist retains overall responsibility for the treatment plan.
Avoiding abandonment
Abandonment is ending the relationship without adequate notice or without ensuring continued care. Proper termination includes written notice, a non-retaliatory explanation, emergency coverage for a reasonable period, an offer to transfer records, and time for the patient to find another provider. Nonpayment or repeated no-shows can justify dismissal - but only through that process.
Traps
Treating "the patient never came back" as a discharge; using a family member as interpreter for a consent discussion; steering referrals to a business the provider owns without disclosure; refusing to treat a patient with a disability instead of accommodating.
Worked example: A patient repeatedly misses appointments and owes a balance. Send written notice of dismissal, state that emergency care is available for a defined period, offer records transfer, and document the mailing. Anything less risks an abandonment complaint.