Background: Being ``fired'' by a patient is an uncomfortable, distressing, and awkward experience for most clinicians. Palliative care clinicians may be at increased risk of termination of the patient-physician relationship for a variety of reasons. Little has been written about the experience of patient-initiated termination of the patient–physician relationship, and to our knowledge, nothing has been written that is specific to palliative care.
Objective: To discuss the experience of termination, offer a framework for learning from and coping with the experience, and make recommendations for how to meet patients' needs after the termination.
Design: Case study and conceptual analysis of three cases from the experience of a palliative care fellow.
Conclusions: The experience of patient-initiated termination of the patient-physician relationship can raise issues of rejection and self-doubt in the palliative care clinician, but can also provide important opportunities for growth, reflection, and learning. In some cases, re-connecting with the patients' families may be appropriate and beneficial for both the clinician and family.
