Friday, February 29, 2008
You're fired
When doctors fire patients. Most commonly happens during sustained non-compliance or appointment no-shows.
Posted by Kevin |
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Comments:
It read to me like the woman needed help with her depression more than the lung-whatever.
# posted by 
: 11:58 AM
: 11:58 AM
Hard to fault either side here.
I would second (from personal experience) the description of how a patient feels afterward: like a worthless piece of crap, especially if risk managers get involved, block communication with anyone else, and refuse to explain why the termination occured when no warning was given and none of the usually presented causes (such as Kevin states to here) applies. You feel embarassed, ashamed, sub-human, and you don't know what the hell you did. After four years I'm still very bitter about it. And I wasn't suffering from depression.
Communicate first..."fire" as a last resort.
I would second (from personal experience) the description of how a patient feels afterward: like a worthless piece of crap, especially if risk managers get involved, block communication with anyone else, and refuse to explain why the termination occured when no warning was given and none of the usually presented causes (such as Kevin states to here) applies. You feel embarassed, ashamed, sub-human, and you don't know what the hell you did. After four years I'm still very bitter about it. And I wasn't suffering from depression.
Communicate first..."fire" as a last resort.
# posted by : 12:58 PM
: 12:58 PM
It also seems to me from reading the article that she called and cancelled the appointment rather than no-show. If she called the same day, it is a problem. But if she gave advance warning e.g. called a week in advance, I don't see what the problem is.
The article also didn't say if the doctor tried referring her to mental health specialist first.
In terms of non-compliance - in some cases the line between non-compliance and patient's right to refuse treatment. We all should have a right to refuse defensive tests or even recommended preventive care - e.g. screening or statins for primary prevention without fear that we'd be "fired".
The article also didn't say if the doctor tried referring her to mental health specialist first.
In terms of non-compliance - in some cases the line between non-compliance and patient's right to refuse treatment. We all should have a right to refuse defensive tests or even recommended preventive care - e.g. screening or statins for primary prevention without fear that we'd be "fired".
# posted by : 1:20 PM
: 1:20 PM
Being fired for not following up doesn't mean a condemnation of the person's character--it means that the doctor is not comfortable being responsible for the person's medical care with the level of follow-up that is occurring. Whether it is attributed to depression, child care, work responsibilities, never having gas for the car, whatever---it just isn't happening. All the colorful excuses are just smoke screen. How do depressed people get to their psychiatrists?
# posted by : 8:50 PM
: 8:50 PM
"Being fired for not following up doesn't mean a condemnation of the person's character--it means that the doctor is not comfortable being responsible for the person's medical care with the level of follow-up..."
And if termination letters were written with this kind of explanation, patients would understand. But they are not. Clinic risk managers don't allow such detail. You get a terse, catch-all statement such as "Due to past interactions.." and the phone number of your insurance provider to call for seeking other care. If you ask questions, you get the same answer: "You were terminated due to past interactions. This is our final decision."
Maybe the doctor don't intend for the action to be a condemnation, but after the lawyers get involved that's exactly what it is. You guys need to appreciate that before taking such drastic measures. What you intend may not be the action that actually gets carried out.
And if termination letters were written with this kind of explanation, patients would understand. But they are not. Clinic risk managers don't allow such detail. You get a terse, catch-all statement such as "Due to past interactions.." and the phone number of your insurance provider to call for seeking other care. If you ask questions, you get the same answer: "You were terminated due to past interactions. This is our final decision."
Maybe the doctor don't intend for the action to be a condemnation, but after the lawyers get involved that's exactly what it is. You guys need to appreciate that before taking such drastic measures. What you intend may not be the action that actually gets carried out.
# posted by : 7:17 AM
: 7:17 AM
"lawyers get involved" That's exactly right. And that's why the doctor is more likely to fire rather than work things out. Why take the risk with a non-compliant patient? When there's a complication, they just come back with a lawyer willing to shoot for the jackpot on failure to warn, the standard of care being whatever you did not do this time.
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# posted by : 8:38 PM
: 8:38 PM
