Saying Goodbye To Patients

Terminating Treatment

Saying goodbye to psychiatric patients is a unique process that is much different than with other patients. Psychiatry is based on emotions, thoughts and behaviors while still maintaining professional patient boundaries. During your time with a psychiatric patient, you will come to develop a bond or attachment with them; each patient has a unique story. Knowing how to say goodbye is very important for both the psychiatrist and the patient.

Perhaps the most important factor is telling the patient ahead of time that you will be terminating treatment with them. Sometimes it’s the other way around: the patient terminates treatment with the psychiatrist. Either way, it’s always best if both parties are made aware at least one month in advance.

Disclosing last minute goodbyes can be especially detrimental to a patient’s well-being. Patients often become very attached to their psychiatrists; perhaps the only people who seem to understand them. When that is suddenly taken away from them, they often mentally decompensate and revert back to their previous self-destructive thoughts and behaviors.

There are several reasons why a psychiatrist may terminate treatment:

  • They are in residency training and are moving on to a new rotation
  • They are in the process of obtaining a position at another hospital
  • The patient has been referred to another psychiatrist
  • They are retiring

On the other hand, there are several reasons why a patient may terminate treatment:

  • They are seeking another psychiatrist
  • They are moving to a new location
  • They no longer require or desire treatment
  • They no longer feel comfortable with the psychiatrist

Whatever the reason, letting the other party know about their departure one month ahead of time, is the right way to go about the process. One month is plenty of time to allow the thought of termination to sink in for both parties. It provides enough time for emotions to be processed and arrangements to be made.

It’s never easy to terminate treatment with a psychiatric patient. Many easily decompensate even after they’ve been informed a month prior. Psychiatrists have to be able to reconnect with their patients and explain that what is most important is for them to remain focused on their treatment, regardless of who their new psychiatrist will be.

Whether personal or professional, all relationships eventually come to an end; it’s just part of life. The factor that separates early termination of relationships from late termination is time. The big picture always comes down to time; how and why are just the details. So rather than getting stuck on the details, always look at the big picture.

It’s not the end of the world if a physician-patient relationship comes to an end. The important thing is that the patient and psychiatrist recover smoothly, and continue to focus on improving themselves mentally, physically and spiritually.

Are you Ready? (This is Defeating Stigma Mindfully)


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