Apr 19 2009

Doctors “Fire” Patients – and Patients Respond

firedpatient

Many of you, my readers, have had complaints about the healthcare system, including the relationship you have (or don’t have) with a doctor. And I hear you — I’ve had bad experiences with some doctors, too.

But that begs the question — do doctors have complaints about patients, too?

Of course they do!  I asked, and received input from more than three dozen healthcare professionals.  I learned:

Ha!  Opened the floodgates, I did.  You’ll be amazed at some of the stories.

Since then, I’ve come across this question from KevinMD – and commentary by one of his responders that suggests that rather than fire his patients, he just makes them so miserable that they choose to leave him. (find comment from MANALIVE)

Have you been frustrated by a meeting with your doctor?  Have you received a letter telling you the doctor will no longer work with you?

I invite you to share your story, too — and to discover whether you fit one of those patient profiles that doctors really just don’t want to work with.

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6 comments

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    • Marilyn Mann on April 19, 2009 at 1:49 pm

    Yes, I have had such an experience. My teenage daughter has heterozygous familial hypercholesterolemia. I took her to the Johns Hopkins lipid clinic in 2007. The doctor there wrote a prescription for Vytorin (simvastatin/ezetimibe). I told him I preferred that my daughter take a statin only. He refused to treat her, although he did refer her to another doctor.

    • DrV on April 19, 2009 at 2:06 pm

    This idea of firing patients is very interesting. The relationship between doc and pt is just that, a relationship. I think as docs we sometimes feel that we have to tolerate bad behavior. While there’s lots to talk about, I really think that termination of dysfunctional relationships is not a bad thing

    • Anonymous MD on April 19, 2009 at 2:27 pm

    MDs firing patients for differences of opinion seems a little extreme, but by the same token some patients will demand a course of treatment completely different and then expect the MD to back them up. Particularly on immunizations, this is a really sore point. Having your own opinion is one thing, but it may be in the best interests of patients who do strenuously disagree to find someone else. It’s our license, not yours.

    I have never fired a patient for disagreeing with me, but I have made it clear where I think theyare mistaken. Sometimes they come back and we go on from there, sometimes they don’t, and I always document what my advice was and what they decided to do about it in as objective a method as possible. I haven’t fired many patients, but abusive patients have no place in my office. If you get nasty with me or my staff, I’ll refund your money and show you the door. But you can demur; just don’t expect me to back you up if I don’t agree.

  1. I run across this all the time when I lecture on the concept of the patient centered medical home to doctors in primary care. I say that one can not give up on their patient that sometime in say 9th grade a teacher did not give up on you and look where you are now. the doctor patient relationship has the potential of being very very powerful. But I do think there can come a time when the doctor and the patient can have a frank chat about wither they are right for each other. I was with a patient in Texas two weeks ago and she said the best thing that every happen to me was 10 years ago I had a very honest sincere doctor who said i do not think we click and I know Dr Jones who seem to see and interact with the world that might really fit your needs. Well she is so very happy with Dr Jones now!

    But fire well I would rather think of it as honest look at what is best for the patient.

    • Angry patient on March 22, 2010 at 4:21 pm

    I had been a patient at a very large practice that included about 2/3’s of Sarasota. I had been a patient of my doctor for about 10 years and had no problems. I went to him with an infection and was treated. About a year later I returned for the same issue and was treated inappropriately. He said he would not issue antibiotics even though it was clear it was an infection. When I asked about it and said I had gotten antibiotics for the same issue a year previously, he got rude and said “Who did that?” and I responded “You did!” He wrote a script for a couple days and made a rude comment about a woman my age and what my problem was and I was out of line.

    I indicated in a follow-up phone call that I felt he was out of line. About a week later I received a registered letter saying that I was being dismissed from the practice and would no longer be able to see ANY doctor from the entire practice. (Remember that it includes about 2/3’s of Sarasota.) I talked with the manager of the practice and she said that the doctor refused to back down and there was nothing else I could do.

    I ended up finding another doctor who then referred me to a specialist for the antibiotics that I was on for almost 4 months including a course of IV antibiotics – so I wasn’t wrong – the original doctor was. I tried to talk with the AMA in Florida, with no results. I was hoping to be able to deal with another doctor within the practice but had to settle for care with a single practitioner that severely limits my medical care.

    I truly feel that I did nothing wrong and was wrong dismissed from the practice by a power hungry, malpractice afraid doctor who valued his pride and pocketbook over the care of patients.

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