"If you quit, it's patient abandonment."
That statement — whether whispered by colleagues or used directly by leadership — is all too familiar for rehab professionals. Speech-language pathologists (SLPs), occupational therapists (OTs), and physical therapists (PTs) across the country hear this line whenever they begin to set boundaries or consider leaving a role that's burning them out. But here's the truth:
Leaving a job is not patient abandonment.
This phrase has been weaponized by administrators, staffing managers, and systems that are more concerned with coverage and revenue than patient care or clinician well-being. It's time to set the record straight.
What Patient Abandonment Actually Means
Patient abandonment is a legal term — and one that carries specific criteria. It is not simply "leaving a job." Here is the definition most commonly upheld in malpractice law:
Patient abandonment occurs when a provider terminates the provider-patient relationship without reasonable notice or without arranging for appropriate care continuity, and the patient suffers harm as a result. (American Medical Association, n.d.).
To meet the legal threshold, all of the following must be true:
- A provider-patient relationship existed.
- The provider ended the relationship.
- The provider failed to give reasonable notice or arrange a transition.
- The patient was still in need of care.
- The patient experienced harm due to the lack of care.
If any one of these criteria is not met — for example, if reasonable notice was provided, or if the patient was not harmed — then it is not abandonment.
Why Employers Use the Word "Abandonment"
Let's be blunt: the use of this term is often about control. It's about scaring clinicians into staying — even when workloads are unsafe, compensation is unfair, and policies are exploitative.
When companies equate your departure with abandonment, they are not protecting patients — they are protecting their staffing model and their profits. Many systems are built to squeeze every last unit out of their clinicians, and when you walk away, they lose revenue. The abandonment myth is designed to make you feel responsible for the cracks in their infrastructure.
How to Leave Ethically and Professionally
You can absolutely leave a job — even without notice — and do so in a way that honors both your patients and your profession. Here's how:
1. Plan ahead
Stop taking new referrals and begin preparing your caseload for transition. Determine who can be discharged, who may need a referral, and what follow-up might be required.
2. Communicate in writing
Provide your employer with notice — whether it's two weeks or immediate — and document your reasons, your transition plan, and the status of your patients.
3. Offer a handoff
Include a summary of goals, progress, and suggestions for continuity. If you know local colleagues who may be a good fit, offer those as referrals. This is a professional courtesy, not your legal obligation.
4. Document everything
Save emails, texts, and files related to your departure before you resign. If a supervisor or HR team tries to threaten your license or question your professionalism, you'll have your own receipts.
5. Protect yourself first
Leaving an unsafe, abusive, draining, or underpaid job is not selfish — it's survival. You are allowed to choose your health, your family, your finances, and your future.
What If You're PRN, Contract, or Temporary?
These roles are inherently transitional. If you're a PRN therapist, a traveler, or filling in temporarily, you are not the primary provider of record. The law accounts for this. Your departure is expected and built into the system, especially if there's no permanent offer or continued care plan in place.
Likewise, leaving mid-assignment in a toxic situation does not equate to legal abandonment, especially if you've given notice and attempted a handoff.
You Are Not the Problem. The System Is.
In rehab therapy, we are taught always to put patients first. And while that's admirable, we must also recognize that burned-out therapists don't deliver the best care. Exhausted, underpaid, abused, burnt-out, overworked clinicians aren't heroes — they're being exploited.
Companies that don't compensate you appropriately, refuse to hire support staff, or expect you to act as both therapist and admin are the ones setting patients up for care gaps — not you.
You didn't go to school, pass boards, and earn a license to be guilt-tripped out of protecting your peace.
In Summary: Know Your Rights
- Leaving a job with or without notice is not inherently patient abandonment.
- Employers are responsible for staffing — not individual clinicians.
- The legal threshold for abandonment is high, and few scenarios in outpatient, home health, or school settings actually meet it.
- Setting boundaries, resigning, or advocating for yourself is not unethical — it's essential.
If your departure is met with guilt, threats, or manipulation, know that those are 🚩red flags🚩, not rules. You're not walking away from your patients. You're walking away from a system that refuses to change — and that's not abandonment. That's leadership.
Listen to the full conversation:
"Abandoning the System, Not the Patient" — now streaming on the Fix SLP podcast.
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