Ethical Approach for Managing Patient–Physician Conflict and Ending the Patient–Physician Relationship

Physicians have an ethical obligation to foster a therapeutic alliance with their patients. If the therapeutic relationship becomes strained, physicians should attempt to resolve the conflict, when possible, through intentional patient–physician discussion or through a third-party mediator. If return to a therapeutic relationship is not possible or mutually desirable, ending the patient–physician relationship may be the best option for the patient and the physician. This Committee Statement provides an ethical framework for managing patient–physician conflict and evidence-based tools and interpersonal interventions to help rebuild meaningful connection with patients. Guidance for the ethical termination of care when the therapeutic alliance cannot be restored also is provided, including institutional responsibilities to patients and physicians.