Patient Safety Alert 30: Informed Patient Refusal in Virtual Care

The AMC PSO and the CRICO Primary Care Physician Leaders recently convened to consider the issue of patient refusal when a primary care physician recommends an in-person clinic visit instead of virtual care.


  • How do you feel when your patient decides not to follow your recommendation for in-person evaluation or treatment? Does it feel adversarial? How can you maintain a therapeutic alliance?
  • How can I clearly communicate the risks of refusal to my patient and maintain a therapeutic alliance?
  • Who makes the decision about virtual versus in-person care? Do you explain the limitations of virtual care versus an in-patient encounter to your patients?

Learn how you can help mitigate risks involved with these topics and more.

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How would you document this encounter in the medical record? Learn more about patient refusal.



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