How do you handle requests for medication refills from patients who were formally terminated from care but report difficulty accessing a new psychiatrist?  

It is essential when terminating a patient that you provide at least three formal referral names with a 30-day notice. One of these should be an agency that cannot refuse patients. This could be a county or state mental health clinic. If the referrals you provide refuse the patient, then you are obl...

This is a common situation that causes a great deal of angst and confusion among all medical specialties, not just Psychiatry. First, the context: the question posits an appropriate formal discharge. Next, it is important to note that while this discussion addresses issues with legal implications, ...

In the unusual event of terminating a relationship with a patient, we allow a 60-day period for them to establish elsewhere. In our community, this is sufficient time. Patients are explicitly told we will not write after 60 days, and if there is a risk of withdrawal, they are warned about this, incl...

When I receive a refill request from someone who has been formally terminated from care, I treat it less like a medication decision and more like a boundary clarification with patient safety as the guardrail. Termination means the therapeutic contract has ended, and I am careful not to quietly re-en...