PHARMACIST STEVE

A hospital system and its employed physicians have an ethical and some legal responsibilities to support continuity of care when a PCP retires, especially for chronic pain patients who are at heightened risk of abandonment if alternative care isn’t arranged. While individual physicians must notify patients, provide reasonable transition time, and continue care until proper hand off or substitute care is found, large hospital systems should facilitate this process—particularly when there are other PCPs in the same office or network.norcal-group+5

Hospital System Responsibilities

Hospital systems are expected to prevent abandonment by providing notice to affected patients and helping arrange ongoing care, either within the network or by supplying resources to find new providers. Given that your scenario involves a large system with multiple PCPs at one site, failure to offer any assistance or access within their network would constitute poor practice and might risk formal abandonment, especially if the patient is left without appropriate medical oversight or prescription management. Ethically, and under many state regulations, systems employing hundreds or thousands of physicians have added capacity (and expectation) to reassign patients internally, compared to solo or small practices.pmc.ncbi.nlm.nih+5

Chronic Pain and Risk of Abandonment

Chronic pain patients face particular vulnerability due to the complexity of their treatment regimen and the stigma attached to opioid prescribing. Abrupt discontinuation or refusal to transition care exposes them to avoidable harm and potential withdrawal, which courts and medical boards may interpret as gross negligence or reckless abandonment if reasonable transition is not achieved. Professional guidelines and precedents (AMA Code, Joint Commission pain standards) reinforce hospital and PCP duties to ensure patients are not left untreated or unsupported.pmc.ncbi.nlm.nih+4

Opinion

In this case, the hospital system should proactively facilitate PCP continuity—either by transferring care to another physician within the practice or by providing written notice and assistance in locating an appropriate provider. Failure to do so risks formal patient abandonment, especially when the system has adequate resources for such a transition. The patient in question could justifiably feel abandoned; advocacy (with state boards, patient relations, or medical directors) may be warranted if transition support isn’t provided.copic+5