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How to say goodbye


Parting ways with patients and staff is a difficult and emotional process. Here’s some gentle guidance.

There comes a time when every practitioner will have to bid farewell to a staff member, patient, colleague, or community. Whether it’s because someone is terminally ill or moving away, these sensitive goodbyes can be challenging.

Here are some common send-off scenarios with suggestions for how to say so long.


Illness or death

When my friend was in the final phase of Stage IV breast cancer, she set the bar high for saying goodbye. A retired RN who was pragmatic at heart, she knew there was no hope for her survival.  In her last days of cognition, she sent personalized thank you notes to the people who had touched her life. Her closing words still resonate with me. She wrote, “Farewell. I shall miss seeing you.” What a profoundly simple and thoughtful message.

Doctors need to know how to say goodbye with grace, too. Being the person who notifies someone about their imminent death and accompanies them on their final journey is a sacred position. That’s why it’s so important for medical practitioners to feel comfortable offering a heartfelt farewell when the time comes.

Still, it’s natural to agonize over what to say to the dying. A simple and sincere statement like the one my friend shared can suffice. Offering a similar sentiment to their loved ones goes a long way toward their healing, too.

When it’s a doctor who is facing his or her own mortality, it’s only fair to let patients know that there will be a change in the practice. Since it’s probably impractical to notify patients one by one, a concise general announcement will usually suffice. There’s also the chance that a physician will die unexpectedly, in which case their executive or administrative team will need to promptly decide on a plan of action for notifying patients and colleagues of the sudden death.


Retirement or relocation

A strong physician-patient relationship takes time to develop. Losing a trusted doctor for any reason, including retirement or relocation, can be difficult for patients. But it’s not only patients who will need to accommodate the change: Clinic staff will also be affected.

It’s respectful to offer an explanation to both groups well in advance of closing, selling, or moving a practice. Employees should be notified first so they can begin adjusting their career plans. Letting staff know about the change before patients means they can also help spread the word in a considerate and efficient manner.

One of the final acts of compassion a physician can offer patients is to provide ample time for them to absorb the news of departure. Adding recommendations for practices that are accepting new patients and helping with the transfer of medical files are other caring gestures.

Disagreement or disharmony

Not every relationship works out. It’s likely that at least once in a physician’s career, he or she will have to part ways with a colleague, a group, or a patient.

If all efforts to mediate differences between parties have failed, it’s time to let the relationship go. When it comes to staff, most medical practices have policies in place for terminating an employee. If they don’t, they need to create some. These policies must be followed to the letter to avoid any potential problems down the road.

Medical partnerships that decide to disband will benefit from having legally binding, documented, and signed dispute and dissolution clauses in their contracts from the get-go. No matter how well practitioners get along in the beginning, it is prudent to discuss the eventuality of the partnership dissolving long before it actually comes to an end.

Whether because of distrust, disrespect, or dispute, sometimes patients need to be released from a practice. There are ethical and professional standards to be followed in these cases. The process of severing patient connections can range from being difficult to being frightening. Having a well-thought-out statement, a witness, a firm tone, and fixed boundaries can ease the gravity of the situation, though it’s rarely an easy thing to do.

No matter what circumstances lead to the need to say goodbye, preparation and forethought are the keys to easing the transition. And in some cases, as demonstrated by my dearly departed friend, it never hurts to end with, “I shall miss seeing you.”

Sue Jacques is a professionalism expert, keynote speaker, consultant, and author who specializes in medical and corporate civility. A veteran forensic medical death investigator, Jacques helps people and practices prosper through professionalism. More information is available at www.SueJacques.com.

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