Discontinuation of Service

Revised: August 2009
Updated: November 2014

If you feel you can no longer provide care to a patient—because, for example , the patient is abusive to you or your staff, or you learn that the patient has lied to you and you feel you have lost the trust necessary to provide care—it is possible for you to discontinue services. Before doing this, however, you must meet the requirements under the Optometry Act. Ontario Regulation 119/94 defines the discontinuance of needed professional services as an act of professional misconduct, unless

  1. the patient requests the discontinuation,
  2. the member arranges alternative services,
  3. the patient is given a reasonable opportunity to arrange alternative services, or
  4. the patient has failed to make payment within a reasonable time for services received, and the services that are needed are not of an emergency nature.

If you are initiating the discontinuation and you choose to arrange alternative services, you should do this in the same way you make a referral, by contacting the other practitioner and providing either copies of your clinical records or a summary report of the care you provided. As an alternative to this, you may notify your patient that on a specific date in the future you will no longer provide care and that in the meantime he or she would be well advised to seek the services of another practitioner. When setting the date after which your services will no longer be provided, you should be sensitive to such factors a s local availability of care and to your patient’s ability to travel , as well as his/her clinical condition. You should also be prepared to provide either copies of your clinical records or a summary report of your care to the patient’s new optometrist. In either situation where you have discontinued service, it would be inappropriate to charge the patient for forwarding copies of the clinical records or for preparing a report.

When you discontinue services, it is critical to make the patient understand that it is in his/her best interest for you to transfer care to another practitioner. If appropriate, inform the patient that you will transfer their file to the practitioner of their choice. Above all, remember to maintain your professionalism throughout the period of transition.