When a patient decides to leave the hospital before their treating physician recommends discharge, it’s known as “discharge against medical advice” (AMA).
This decision can have serious consequences for the patient’s health and well-being.
Sample Letters of Discharge Against Medical Advice
In such cases, the patient is often asked to sign a form acknowledging their decision to leave and the potential risks involved.
The following 15 sample letters provide examples of how a patient might communicate their decision to leave AMA, as well as how healthcare providers might respond.
Letter 1: Patient’s Declaration of Discharge Against Medical Advice
Subject: Discharge Against Medical Advice
I, [Patient Name], hereby declare my intention to leave [Hospital Name] against the advice of my treating physician, Dr. [Physician Name]. I understand that by leaving the hospital before my recommended discharge date, I risk potential complications and negative outcomes related to my current medical condition.
I acknowledge that I have been informed of the risks associated with leaving against medical advice, and I assume full responsibility for any consequences that may result from my decision. I release [Hospital Name] and its staff from any liability related to my choice to leave AMA.
Signed,
[Patient Name]
Date: [Current Date]
Letter 2: Physician’s Response to Patient’s Decision to Leave AMA
Subject: Response to Discharge Against Medical Advice
Dear [Patient Name],
I have been informed of your decision to leave [Hospital Name] against my medical advice. As your treating physician, I have to ensure that you understand the potential risks and complications associated with leaving the hospital before your recommended discharge date.
Your current medical condition requires further treatment and monitoring, and leaving AMA may result in serious health consequences. I strongly urge you to reconsider your decision and continue with the recommended course of treatment.
If you choose to proceed with leaving AMA, please sign the attached form acknowledging your understanding of the risks involved and releasing [Hospital Name] and its staff from any liability related to your decision.
Sincerely,
Dr. [Physician Name]
Letter 3: Patient’s Request for Discharge Planning Assistance
Subject: Request for Discharge Planning Assistance
Dear [Hospital Staff],
I, [Patient Name], have decided to leave [Hospital Name] against medical advice. However, I would like to request assistance with discharge planning to ensure a smooth transition and continuity of care.
Please provide me with information regarding follow-up appointments, medication prescriptions, and any other necessary instructions to manage my care after leaving the hospital. I understand that leaving AMA may have consequences for my health, but I believe I can better manage my condition at home with the appropriate resources and support.
Thank you for your assistance in this matter.
Sincerely,
[Patient Name]
Letter 4: Healthcare Provider’s Acknowledgement of Patient’s Decision
Subject: Acknowledgement of Discharge Against Medical Advice
Dear [Patient Name],
We have received your request for discharge planning assistance and acknowledge your decision to leave [Hospital Name] against medical advice. While we respect your right to make decisions about your healthcare, we want to emphasize the importance of following your treating physician’s recommendations.
Our staff will provide you with the necessary information and resources to help manage your care after leaving the hospital. However, please be aware that leaving AMA may result in complications or negative outcomes related to your current medical condition.
We strongly encourage you to reconsider your decision and continue with the recommended course of treatment. If you have any questions or concerns, please do not hesitate to discuss them with your treating physician or our hospital staff.
Sincerely,
[Healthcare Provider Name]
[Hospital Name]
Letter 5: Patient’s Explanation for Leaving AMA
Subject: Explanation for Discharge Against Medical Advice
Dear Dr. [Physician Name],
I appreciate the care and attention I have received at [Hospital Name], but I feel it is necessary to leave against medical advice due to personal reasons. I understand that you have recommended continued treatment, but I believe I can manage my condition more effectively at home.
Please know that my decision to leave AMA is not a reflection of the quality of care provided by you and the hospital staff. I have personal matters that require my immediate attention, and I feel that I cannot address them while hospitalized.
I request your assistance in providing me with the necessary information and resources to manage my care after leaving the hospital. I will follow up with you or another healthcare provider as soon as possible to ensure continuity of care.
Thank you for your understanding and support.
Sincerely,
[Patient Name]
Letter 6: Physician’s Documentation of Patient’s Discharge AMA
Subject: Documentation of Discharge Against Medical Advice
Patient Name: [Patient Name] Date of Birth: [Patient’s Date of Birth] Medical Record Number: [Patient’s Medical Record Number]
On [Date], [Patient Name] informed me of their decision to leave [Hospital Name] against medical advice. I have explained the potential risks and complications associated with leaving AMA, including [list specific risks related to the patient’s condition].
The patient has acknowledged their understanding of these risks and has chosen to proceed with discharge AMA. They have signed the appropriate forms releasing [Hospital Name] and its staff from any liability related to their decision.
I have provided the patient with information regarding follow-up care and instructions for managing their condition after leaving the hospital. The patient has been advised to seek immediate medical attention if they experience any worsening symptoms or complications.
Signed,
Dr. [Physician Name]
Date: [Current Date]
Letter 7: Patient’s Request for Medical Records
Subject: Request for Medical Records
Dear [Hospital Records Department],
I, [Patient Name], recently left [Hospital Name] against medical advice on [Date]. I am writing to request a copy of my medical records from my stay at the hospital.
Please include all relevant information, such as admission and discharge summaries, diagnostic test results, medication lists, and treatment plans. I authorize the release of these records to myself or to any healthcare provider I designate.
Thank you for your prompt attention to this matter. Please contact me at [Patient’s Contact Information] if you require any additional information or documentation.
Sincerely,
[Patient Name]
Letter 8: Hospital’s Response to Patient’s Request for Medical Records
Subject: Response to Request for Medical Records
Dear [Patient Name],
We have received your request for a copy of your medical records from your recent stay at [Hospital Name]. We are processing your request and will provide you with the requested documents as soon as possible.
Please note that there may be a fee associated with the copying and mailing of your medical records. We will inform you of any costs before processing your request.
If you have any questions or concerns, please contact our Records Department at [Hospital Records Department Contact Information].
Sincerely,
[Hospital Records Department Representative]
[Hospital Name]
Letter 9: Patient’s Agreement to Comply with Follow-Up Care
Subject: Agreement to Comply with Follow-Up Care
Dear Dr. [Physician Name],
I, [Patient Name], am writing to inform you of my commitment to comply with the follow-up care plan we discussed before I left [Hospital Name] against medical advice.
I understand the importance of continuing my treatment and monitoring my condition to ensure the best possible outcomes. I will attend all scheduled appointments, take my prescribed medications as directed, and promptly report any changes in my symptoms or overall health.
Please let me know if there are any additional steps I should take to manage my care effectively. I appreciate your ongoing support and guidance.
Sincerely,
[Patient Name]
Letter 10: Physician’s Acknowledgement of Patient’s Agreement to Comply
Subject: Acknowledgement of Agreement to Comply with Follow-Up Care
Dear [Patient Name],
Thank you for your letter expressing your commitment to comply with the follow-up care plan we discussed before you left [Hospital Name] against medical advice. I am pleased to hear that you understand the importance of continuing your treatment and monitoring your condition.
Please remember to attend all scheduled appointments, take your prescribed medications as directed, and promptly report any changes in your symptoms or overall health. If you have any questions or concerns, do not hesitate to contact me or my office.
I will continue to support you in managing your care and ensuring the best possible outcomes for your health.
Sincerely,
Dr. [Physician Name]
Letter 11: Patient’s Notice of Transition to Another Healthcare Provider
Subject: Notice of Transition to Another Healthcare Provider
Dear Dr. [Physician Name],
I, [Patient Name], am writing to inform you that I have decided to transition my care to another healthcare provider. As you know, I recently left [Hospital Name] against medical advice, and I believe that a change in my healthcare team will be beneficial for my overall well-being.
Please forward my medical records to [New Healthcare Provider’s Name and Contact Information]. I authorize the release of these records to ensure a smooth transition of care.
Thank you for the care and treatment you have provided during my time at [Hospital Name]. I appreciate your understanding and cooperation in this matter.
Sincerely,
[Patient Name]
Letter 12: Physician’s Response to Patient’s Transition Notice
Subject: Response to Notice of Transition to Another Healthcare Provider
Dear [Patient Name],
I have received your notice regarding your decision to transition your care to another healthcare provider. While I respect your right to make decisions about your healthcare, I want to emphasize the importance of continuity of care, especially given your recent discharge against medical advice from [Hospital Name].
I strongly encourage you to reconsider your decision and continue your treatment with our healthcare team. We are familiar with your medical history and have developed a comprehensive plan to manage your condition.
If you choose to proceed with the transition, please complete the necessary authorization forms to release your medical records to your new healthcare provider. We will process your request promptly to ensure a smooth transfer of care.
If you have any questions or concerns, please do not hesitate to contact me or my office.
Sincerely,
Dr. [Physician Name]
Letter 13: Patient’s Request for Assistance with Insurance Coverage
Subject: Request for Assistance with Insurance Coverage
Dear [Hospital Billing Department],
I, [Patient Name], recently left [Hospital Name] against medical advice on [Date]. I am writing to request assistance with understanding my insurance coverage and any potential financial consequences related to my decision to leave AMA.
Please provide me with information regarding the billing process, any charges I may be responsible for, and how my insurance will handle the costs associated with my hospital stay. I would also appreciate guidance on how to appeal any denied claims or negotiate a payment plan if necessary.
Thank you for your assistance in this matter. Please contact me at [Patient’s Contact Information] if you require any additional information or documentation.
Sincerely,
[Patient Name]
Letter 14: Hospital’s Response to Patient’s Request for Insurance Assistance
Subject: Response to Request for Assistance with Insurance Coverage
Dear [Patient Name],
We have received your request for assistance with understanding your insurance coverage and the potential financial consequences related to your decision to leave [Hospital Name] against medical advice.
Our billing department will review your account and provide you with a detailed breakdown of the charges associated with your hospital stay. We will also assist you in understanding your insurance coverage and any potential out-of-pocket expenses.
If your insurance provider denies any claims related to your hospital stay, we can guide you through the appeals process and help you explore alternative payment options, such as setting up a payment plan.
Please be aware that leaving against medical advice may impact your insurance coverage, and you may be responsible for a larger portion of the hospital charges than if you had been discharged as recommended by your treating physician.
If you have any further questions or concerns, please contact our Billing Department at [Hospital Billing Department Contact Information].
Sincerely,
[Hospital Billing Department Representative]
[Hospital Name]
Letter 15: Patient’s Expression of Gratitude for Care Received
Subject: Expression of Gratitude for Care Received
Dear [Hospital Staff],
I, [Patient Name], am writing to express my heartfelt gratitude for the care and treatment I received during my recent stay at [Hospital Name]. Although I ultimately decided to leave against medical advice, I want to acknowledge the dedication and professionalism of the entire healthcare team.
Thank you for your compassion, expertise, and tireless efforts in managing my care. I appreciate the time you took to educate me about my condition, treatment options, and the potential risks associated with leaving AMA.
Please know that my decision to leave was not a reflection of the quality of care provided by the hospital staff. I am grateful for the support and guidance I received during my stay.
Thank you again for your commitment to patient care and well-being.
Sincerely,
[Patient Name]
Conclusion
Discharge against medical advice is a complex issue that requires careful consideration and communication between patients and healthcare providers.
These 15 sample letters demonstrate the various perspectives and concerns that may arise when a patient decides to leave AMA.
By maintaining open and honest communication, patients and healthcare providers can work together to ensure the best possible outcomes, even in challenging situations.