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Patients Leaving Against Medical Advice: What You Need to Know

Updated: Jul 31, 2023

a sad little girl whose mother just signed AMA

Unless you work in healthcare, you might not understand why some patients willingly leave a medical facility against medical advice. Doesn’t leaving AMA just put the patient at risk of further injury or perhaps even death? How do these situations arise in the first place? Why would someone want to leave a hospital or other medical facility after being treated there? And what can an organization do to mitigate this risk and keep patients from leaving against their doctor’s orders? Let’s take a closer look at all of these questions and some proven strategies for reducing your organization’s risk of Patients Leaving Against Medical Advice.

AMA Defined

AMA Defined stands for "against medical advice." This term is often used when a patient refuses treatment or discharge from a hospital or other medical facility. AMA patients can't be forced to stay in the facility, but they do put themselves at risk by leaving.

Why do patients leave against medical advice?

Patients may refuse treatment for a number of reasons. They may have unrealistic expectations of what the treatment can achieve or the recovery time. They may feel fine and want to return home. They may feel frightened or confused by the treatment that is being administered. When patients perceive a threat to their identity, they may experience a fight-or-flight response. In this situation, patients may leave the hospital against medical advice to avoid feeling helpless. They may fear they will become a burden to their loved ones if they stay in the hospital longer. They may need to reassert their independence and return to their normal routine.

Strategies to Reduce the Risk of Patients Leaving AMA

  • Educate: Patients who are properly informed about their treatment (including its costs, risks, and benefits) are less likely to refuse it. Doctors and other healthcare providers are trained to deal with these issues, but front-line staff should also be equipped with the knowledge and skills to discuss any concerns they may have about their care and treatment with patients.

  • Create a positive experience: Patients with positive experiences with their care providers are less likely to refuse treatment or leave against medical advice. To create positive experiences, consider how patients and their loved ones are being treated.

  • Create a culture of self-awareness: Treating all staff members with respect, dignity, and empathy can help create a culture of self-awareness. Engaging staff members in discussions about the care they provide and how they can improve the experience for patients and their loved ones can help create a culture of self-awareness.

Consequences of Patients Leaving Against Medical Advice

To reduce the risk of patients leaving against medical advice, doctors and other healthcare providers will try to persuade them to stay. If patients still leave AMA, there could be consequences for the patients themselves. For example, patients who walk out of a hospital against medical advice without being discharged are considered to be “fleeing” and can therefore be arrested or detained. Patients who leave a healthcare facility with active infections or communicable diseases can endanger others in the community. When patients leave AMA and are involved in a car or other accident, there could be legal implications. For example, insurance companies may refuse to pay for damages or injuries, and patients may be charged with a crime. Patients who need ongoing treatment or monitoring may also have to return to the hospital against their will.


Patients leaving against medical advice is a big problem in the United States. It is important for patients, doctors, and hospitals to work together to ensure that patients get the care they need while also respecting their rights. With these strategies and considerations in mind, organizations can work to reduce the risk of patients leaving against medical advice.

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