My two cents less deductible. Im speaking as a patient and a patient who was terminated from the patient-provider relationship.

he is the patient, the spouse is not.  There is no patient-provider relationship with the spouse.  If the husband has been following the doctor's orders, he hasnt provided any reason to terminate his relationship.  The problem with terminating is that it could be viewed as patient abandonment and it could open the doctrior to an abandonment charge.

My situation so you can understand:  I had open heart surgery.  I was under the care of a cardiologist.  He would make appointments, have his staff call to cancel or call to move an appointment. I dont have problems if an appointment needs to change.  The cardiologist told me that he wanted me to have additional surgery.  In my view this was another attempt to make more money off me. Why?  I went for my first post surgery visit, during the global period, and he bills me for a 99215 visit.  He wants another visit 2 weeks later, also during the global period, and that visit is also a 99215. The visits are walk in, take my vital signs which are within normal limits, listen to my chest, then tell me to come back.  Im in and out in less than a minute.  I question his billing and he becomes offended.  During the visit when he says he wants to do more surgery, I ask questions as to why this is needed.  He becomes offended I would question him.  I went to a different doctor who said the surgery was not medically necessary but a test would determine that.  I went to the cardiologist to ask for this test.  He said the test was not needed, that my surgery was scheduled for x date, a few days later.  I refused and informed the doctor that he could schedule the surgery if the test I now demanded showed the surgery was needed and another cardiologist agreed.  The test was scheduled.  I arrived an hour before the start of the test.  There was a sign on the door that the practice moved to a new location.  There wasnt an address on the sign.,  I called the practice number, the answering service answered. They didnt know the new address either.  I asked that they contact the doctor to let the doctor know I was at their old address and I didnt know where to go and to reschedule this test.  A week later, the practice called.  The doctor was highly upset and wanted a meeting to discuss this with me.  I showed up a half hour early.  The staff pulled my chart.  I informed them this was not a medical visit.  They said the doctor wasnt going to be in, that he was off that day and they didnt know about any meeting. I waited for a half an hour and no doctor.  I went to my car. When I got in, the doctor pulled up. He got out and started yelling at me for leaving without seeing him.  We both went into his office.  He came in with the receptionist and  a tape recorder.  I asked why.  He said he wanted this documented and wanted a witness.  I said no problem, went to the lobby and asked a man who was there, if he was a patient.  He wasnt and I asked if he would sit in the meeting. He agreed.  I set my phone on record and told the doctor I had my own witness who wasnt his employee and I would make my own recording.  He didnt like that,  He only wanted his employee in the room and to do only his recording.  We came to an understanding and the meeting started.  The first thing he said was, Im terminating you as my patient.  I asked why.  His response was I wrongfully questioned his medical opinions and medical advice and I missed appointments.  Luckily the man I chose as my witness was a local attorney.  His wife was the patient.  I explained that I had a right to question and I obtained a second opinion from a fellow cardiologist who did not recommend the surgery.  I stated I questiond his billing practices and it was his staff that changed appointments.  His witness confirmed the appointment changes by his staff.  he brought up the missed test.  We called the answering service  They confirmed I called to report that I was at the old practice location but they forgot to pass on the message.  Everything the doctor came up with was destroyed.  he had no case to dismiss.  He asked to have his office manager come to the meeting.  She showed up and we brought all of this back to the table.  I made a recommendation we reschedule the test and go from there.  If the test showed additional surgery was needed it would be scheduled.  She agreed.  A week later, I get a certified letter, from the doctor, announcing he was terminating the patient-provider relationship.  I sent a copy of the letter, all my supporting documentation and a copy of the meeting recording to the State.  I met with a lawyer to discuss a lawsuit for unlawful termination.  I also contacted my insurance company who started an investigation into the claims sent to them.  I was at an appointment with my PCP.  He recommended I restart seeing a cardiologist to help prevent a second stroke I had after I was terminated by the cardiologist.   I was being sent back to the same practice that terminated me but with clear instructions I would see a different cardiologist.  The doctor who terminated me left the practice.  The office manager was replaced as was the receptionist.  Basically they cleaned house.  Ive been under their care for the last 2 years.  My health improved while back under their care. 

My story was to show what it was like to be terminated when you didnt do anything wrong.  Based on what is presented the patient did nothing wrong.  The spouse is the problem and the spouse has no patient-provider relationship.  I get these calls all the time where the spouse who is not the patient will call, not let you get one word in, comes into the office yelling, screaming and using foul and abusive language.   I would send a letter to the patient, informing him of his spouses actions and that they are not acceptable.  The spouse is informed that we cannot speak with his spouse as she is not our patient.   He is informed that she is not allowed onto our property when he presents with his visit.  Any calls or verbal abuse will not be tolerated and will be considered as harassment and disruptive of the patient-provider relationship.   While we wish to continue our patient-provider relationship, we cannot accept this abuse.  He is free to seek care from another provider of his choosing and until he does so, we will continue to provide him with the care we agreed to provide, but, again, his spouse cannot accompany him during his visits unless she is medically needed to assist him with entering and leaving the practice and then, once he is in the office, she must quietly leave the office.  What you dont want is a charge of abandonment by the patient himself.  The doctor who terminated me lost his medical license due to patient abandonment.  He left the practice when he lost his license.  When he left the practice, he left the country.  The lawsuit I filed was dropped.  Before terminating, maybe it would be best to speak with a lawyer.  Being a non-lawyer, you can probably tell the patient his spouse cannot be on private property without permission and that permission is withdrawn.  I dont know if the patient is handicapped where he may need assistance getting inside the practice.  If he is handicapped, he may need his spouse to help him get inside the building.  Once he is in the door, you can now help him navigate the office.  That is when his spouse can leave because there is now a transfer of responsibility and she is not needed to be there during the visit, unless he is also mentally handicapped or medically insufficient to understand medical orders. 

Yes, this is a problem, but you want to protect yourselves and not open the practice to anything that could cause further harm.  He is the patient and from what weve been told hes done nothing to warrant a termination, but that is the non-lawyer in me.  That is the patient in me. 
ell

I am not a lawyer.  My post is not legal advice. You are free to seek a lawyer at your own expense for legal answers. Your asking for my layperson guidance holds me harmless and indemnifies me and the MAB against any and all lawsuits. We are not an approving agency. My name is, and I approve this message!  Im sorry, Im not in at the moment, at the tone, please leave a message.... BEEP!