A family doctor can unilaterally terminate a declaration with a patient — when it is allowed

A declaration with a family doctor, therapist, or pediatrician is not an indefinite guarantee of medical care regardless of circumstances. In cases defined by law, its validity can be terminated not only at the patient's request but also on the initiative of the doctor. However, there must be clear grounds for this, and the decision must be made following the established procedure.

"Judicial and Legal Newspaper" reviewed the relevant rules and explained when a doctor has the right to initiate termination of a declaration, in which cases they cannot refuse a patient, and how the termination procedure takes place.

Declaration with a family doctor: what it guarantees to the patient

A declaration with a family doctor, therapist, or pediatrician forms the basis of the patient's relationship with the doctor at the primary healthcare level. This doctor coordinates the patient's medical care, provides consultations, prescribes necessary treatment, and, if there are medical indications or clinical appropriateness, refers the patient for additional examinations or to specialists.

The patient's right to freely choose a doctor is defined by law. The patient decides with whom to conclude the declaration and can independently terminate it.

At the same time, a doctor has the right to refuse a new declaration only in one case — if the optimal number of patients has already been reached. The maximum number of declarations is:

• for a therapist — 2000;
• for a family doctor — 1800;
• for a pediatrician — 900.

In such a situation, the patient must choose another doctor.

Cases when a doctor cannot refuse a patient

A doctor cannot refuse to sign a declaration due to:

• the patient's place of registration or actual residence, even if they live in another city or region;
• age;
• gender;
• social status;
• financial situation;
• medical history;
• lack of a passport, if the person can provide another identity document;
• status as an internally displaced person.

When a doctor can independently initiate termination of a declaration

There are cases when the declaration can be terminated on the doctor's initiative.

This right arises if the patient:

• systematically does not follow medical recommendations;
• violates the internal regulations of the medical institution.

There is an important condition: termination of the declaration is possible only if such a decision does not pose a threat to the life or health of the patient or the safety of others.

How the termination procedure takes place

If the doctor believes there are legal grounds for termination, they submit a written application to the head of the medical institution specifying the reasons.

Then the head of the institution reviews the application and clarifies all circumstances that led to such a request. The head makes the decision on the presence or absence of grounds for termination of the declaration.

If the decision is positive, the head notifies the National Health Service of Ukraine, providing the necessary patient data, including surname, first name, date of birth, unique declaration identifier, and other required information.

When the declaration is considered terminated

The declaration is terminated 10 calendar days after the National Health Service of Ukraine receives the notification from the medical institution about the need to terminate it.

After that, the primary healthcare institution is obliged to inform the patient or their legal representative about the termination within three working days.

The patient is informed by the method they specified in the declaration as preferred for communication — by phone, email, or another convenient communication channel.

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