Can we mandate patients to get the COVID-19 vaccine to stay in our practice?

There is currently no definitive guidance, at the state or federal level, that answers this question either “yes” or “no.” Generally, practices can discharge patients for any reason, but Curi would not recommend taking the approach of mandating a patient receive the COVID-19 vaccine to remain within the care of your practice. Rather, we recommend that the practice member (preferably a physician) educate and inform the patient about the safety of the vaccine so that the patient can make an informed decision, and hopefully chose to get vaccinated.

Also, we would not recommend discharging an existing patient simply because they have not received the COVID-19 vaccination, unless that is your policy for all vaccines, including the annual flu vaccine.

Curi does believe that practices can decide to not accept any new adult patient without proof of COVID-19 vaccination.

Other considerations:

If you decide to require the vaccine in order for a patient to remain in your practice, are you also mandating this for your employees? Have you asked the patient why they are refusing? Are they claiming a religious exemption or medical exemption? Is your patient in the middle of active treatment that would prohibit dismissal or give rise to a claim of abandonment? Are you doing this consistently among all patients to avoid claims of discrimination?

These are all questions you should address before deciding to dismiss patients for refusing to take the vaccine. As their medical provider, you have a duty to the patient to provide care for the medical condition for which you are seeing them, and you have an obligation to dismiss in a way that allows the patient to find appropriate and timely care from another provider.

The best practice is to take precautions to identify all suspected or confirmed COVID-19 patients, regardless of vaccination status, and take the necessary precautions to avoid exposures. You should be following all CDC-recommended guidelines for screening, and then manage patients according to practice policy for a suspected or confirmed COVID-19 patient. For example, if a patient screens positive, you have options that apply to all patients, regardless of vaccination status, such as placing the patient in a room as soon as appropriate with all staff wearing N95 mask and other appropriate PPE, rescheduling for a tele-visit if appropriate to the care of the patient, and/or referring for follow up care to the appropriate facility for testing and treatment for possible COVID-19.