Patient Abandonment, Referral, and Termination of the Dentist-Patient Relationship
Referral and termination rules
A dentist may refer when the service is beyond the dentist's scope or competence, but the patient retains choice of specialist. The referral must not be conditioned on a fee split or kickback. Terminating the relationship is permitted for legitimate reasons, such as repeated noncompliance or nonpayment, but only with reasonable notice, emergency instructions, and a plan for records transfer. Abandonment is unilateral termination without that protection, especially mid-treatment or when the patient is in need of urgent care.
Records and transition
The patient should receive written notice, usually by certified mail, stating the termination date and how to obtain records. Provide emergency care until the transition is complete. Do not withhold records to collect a fee where the rule requires release.
Worked example
A patient misses two appointments and owes money. The dentist sends a letter giving 30 days, offers to transfer records, and lists nearby clinics for emergencies. That is a defensible termination. If the dentist instead tells the patient by phone 'do not come back' during active root-canal treatment and provides no referral, the conduct looks like abandonment.
Traps that cost marks
Dismissing a patient for discriminatory reasons. Terminating without notice. Refusing to see a patient in an emergency after sending notice. Assuming a signed 'dismissal' form alone satisfies the duty.