Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Supporting Patients When Their Previous Physician Has Left The Practice 


Thoughtful communication with new patients whose longtime clinicians have recently left positions can reduce stress and help develop rapport. 

For longtime patients, the loss or departure of a physician or APP for any reason may feel similar to grief. Many models of bereavement have described anger as a common reaction in the first stages of loss. And the current pandemic and sweeping changes in healthcare delivery may compound the stress of these experiences. Such emotions may initially go unrecognized in new patient encounters, leaving clinicians unprepared to manage them effectively. The result can be a stressful, inefficient encounter and a rocky start to the development of a new patient-doctor relationship. Although it may seem to take up a lot of visit time, direct and thoughtful conversations around clinician transition can ultimately save time and improve the new relationship. 


1. Acknowledge the situation.

Don’t wait for the patient to bring up feelings about their previous physician. It’s more useful to lead with a statement which shows your awareness of the situation, such as: “I know this may be difficult for you. I’m looking forward to being your new doctor and getting to know you.” 


2. Be curious and validate feelings.

Negative feelings may still arise. It’s not uncommon to hear statements like, “I was their patient for over 20 years! What’s wrong with this place? What drove them out of here?” Empathy can help build trust and connection in uncomfortable situations. Here are some contrasting examples: 


Ineffective responses: 

“Look, I don’t know why they left. It’s not my business.”

“I’m not sure what happened, but I have to get to know you myself.”


Effective responses: 

“You seem angry. It must be difficult to lose a doctor whom you’ve trusted for a long time.”

“Tell me what you liked most about Dr. ___.”


3. Respectful silence may also be a form of support. 

Sometimes simply allowing a patient to vent and express disappointment that their clinician has left the practice may help build rapport. 


4. Process your own feelings.

Make time to meet with colleagues, discuss feelings and experiences, and get feedback and ideas. Your emotions matter too; it’s important to express and process them and share them with others who may also be experiencing similar challenges. 






This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.