Posted by Amy Carbone on Aug 22, 2025 9:45:00 AM
As a dentist and a practice manager, you want your schedule and chairs full. You’ve developed strategies to grow your patient list. You’ve trained your team and found ways to keep them happily employed at your practice, all to build positive long-term patient relationships.
Unfortunately, sometimes a patient may not be a good fit for your practice, and you have the uncomfortable task of letting them know they need to find a new dentist.
Before you fire a patient… STOP.
It’s essential to have fully developed patient termination policies that
- Are in full compliance with state laws, rules, and regulations
- Adhere to your state board of dentistry
- Are developed in conjunction with or approved by your legal advisor
In addition, every potential patient dismissal should be reviewed with your malpractice insurance carrier.
Now, let’s take a look at the reasons for and how to “fire” a patient.
5 Reasons to Dismiss a Dental Patient
Repeated Missed Appointments or No-Shows. When patients fail to attend appointments or arrive late, it disrupts their care continuity and impacts your practice’s scheduling efficiency. While occasional conflicts can be understood and deterred with a rescheduling fee, repeated issues may necessitate the termination of services.
Noncompliance with Treatment Recommendations. Patients who don’t follow your treatment recommendations may feel that they are the only one who pays the price of a compromised outcome, but there is a potential liability risk associated with noncompliance. Patient education is always the first line of defense, but this is another reason that could potentially lead to patient dismissal.
Abusive or Disrespectful Behavior Toward Staff. Employees have a fundamental right to work in a place where they are free from verbal abuse, threats, or inappropriate conduct, a right protected by various laws and policies. Any and all abusive or disrespectful behavior toward staff should be immediately addressed in compliance with all laws, and you should discuss concerning situations with your insurance provider.
In consultation with that provider and your malpractice provider, you may need to terminate services to such a patient. Ensure that your patient termination letter due to behavior template allows you to provide the documentation your attorney recommends.
Failure to Pay or Disregard for Financial Agreements. Ongoing nonpayment or refusal to discuss financial obligations can disrupt your practice and erode trust. While occasional hardship can be managed, chronic issues may warrant dismissal. Ensure that your financial policies are clear, well-documented, and distributed to all patients. Provide warnings to patients who are not meeting your policy requirements.
Breach of Office Policies or Ethical Conflicts. When a patient repeatedly violates office policies or requests unethical treatment, dismissal may be necessary to protect your staff and uphold professional standards. Document incidents thoroughly and consult your malpractice insurer and legal counsel before proceeding to ensure your response is appropriate, compliant, and defensible.
How To Fire a Patient the Right Way
Remember, it is essential to consult the relevant laws, your state board of dentistry, and applicable state rules and regulations before you “fire” a patient. You should handle every dismissal professionally to respect each patient’s dignity while protecting your reputation and maintaining a professional practice.
When you first open your practice — or now, whichever comes first — seek legal advice when developing a practice patient termination policy and a template for dismissal letters for your dental patients.
Remember, every potential patient dismissal should be reviewed with your malpractice insurance carrier.
1. Provide Written Notice
Most states require you to provide written notification of your intent to terminate care. This letter should be polite, direct, and nonjudgmental.
Clearly state the reason for dismissal, reference any relevant documentation, and indicate the date care will end. A well-crafted template — customizable for each situation — can help ensure consistency and compliance while maintaining a respectful tone.
2. Offer Emergency or Interim Care
In your written notice, include a defined window during which you will continue to provide emergency or urgent care. Typically, the timeframe is 30 days, although this may vary by state. This ensures patient safety and gives them time to secure a new provider.
Clearly explain the scope of what constitutes emergency care and any limitations that may apply during this transition period.
3. Provide Referrals and a Copy of Records on Request
To support continuity of care, inform the patient that, upon written request, you will provide a copy of their dental records promptly and in accordance with HIPAA regulations. You may choose to direct them to their local dental society or their insurance provider’s directory for assistance in finding another dentist.
4. Document Everything
Thorough documentation is critical. Maintain clear notes in the patient's file about all interactions related to the dismissal, including phone calls, written communications, and observed behaviors. This record may be essential if a complaint or legal issues arise later.
Safeguarding Your Practice
Growing a practice requires an investment of time, effort, and resources — clinically, operationally, and financially. Patient dismissals may be rare, but they can carry legal and reputational risks that threaten your business if they aren’t handled properly.
Documented policies and procedures, coupled with the right insurance coverage for practicing dentists who own their own practices, help protect your investment from the unexpected. To safeguard your practice and your livelihood, download your complimentary copy of The Practice Owner’s Guide to Business Coverage.
About Treloar & Heisel
Treloar & Heisel, an EPIC Company, is a premier financial services provider to dental and medical professionals across the country. We assist thousands of clients from residency to practice and through retirement with a comprehensive suite of financial services, custom-tailored advice, and a strong national network focused on delivering the highest level of service.
Insurance products offered through Treloar & Heisel, LLC.
