Problem: You are the corporate director of risk management. You receive a call from the practice manager at a physician's office. The physician's office is part of your organization's corporation. The practice manager said that he is very concerned. He received a call from a patient saying that he wanted to see the doctor right away. He was asked what his emergency was and he stated that he isn't sick. He just needs to talk with the doctor. When the receptionist said that unless he needs an appointment for medical reasons he can't have an appointment today, he stated that he is sick and is in a lot of pain. The receptionist said that she will talk with the doctor and call him back.

The receptionist reported to the practice manager that the patient was sent a letter terminating him from the practice. The letter was sent 5 days ago. The reason for his termination is that he is a chronic user of narcotic pain medication and he was given a contract to sign re: his narcotic use. He signed the contract and quickly violated the terms of the agreement.

Questions: 1. Based on the termination of a patient from the practice, what are you obligated to do?

2. If there are concerns regarding your obligation, what would you suggest?

3. What would you tell the practice manager to do immediately for the safety of the staff?