Risk Tip

Addressing Parent Accountability With Pediatric Patients

Managing nonadherent and difficult patients is not uncommon in various types of healthcare settings. In practices that treat pediatric patients, healthcare providers might run into issues with parents (or guardians) rather than with the patients themselves. Many pediatric providers can give examples of parents who (a) won’t authorize testing or treatment for their children, (b) fail to follow through with agreed-upon treatment plans, or (c) simply “fade away” before treatment can be initiated or completed. 

Other difficult situations include parents who expect special treatment — accommodations for uncooperative children, preferential appointment scheduling, extended payment schedules, etc. In their desire to appease these parents, healthcare providers may inadvertently inconvenience their staff as well as their other patients. 

The ability to differentiate between providing good customer service and conducting good business practice is vital in the healthcare setting. Ideally, both should reflect the needs of all patients, staff accountabilities, and the standard of care. If not, accommodations that aren’t compatible with the practice’s mission and policies may have unintended negative results for providers, staff, and patients. To address nonadherent or difficult behavior from parents, healthcare providers and staff members can implement various strategies.

Parental nonadherence to pediatric patients’ medical care also might raise questions about suspected child abuse or neglect. Healthcare providers who treat pediatric patients play a vital role in identifying and reporting suspected abuse and neglect and preventing tragedies. 

Healthcare practices should develop an abuse/neglect policy and educate providers and staff members about their reporting obligations under federal and state laws. The practice should consider posting this policy or including it in the welcome brochure so that parents are aware of these regulations. In some instances, providers might need to work with members of other healthcare professions to determine whether a child’s condition warrants a report of suspected abuse or neglect. 


This document should not be construed as medical or legal advice. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions. 

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