Firing patients

Journalistic malpractice.

“When a patient-physician relationship begins, the doctor is under ethical and legal obligations to provide medical services for as long as the patient wants, according to the American Medical Association……”

The AMA says the physician-patient relationship is voluntary and can be terminated by either party.

“First, there has to be a legitimate reason…….”

You can dismiss a patient from your practice for any reason or no reason.

“…..Next, a letter should be sent to the patient via certified mail with a detailed explanation of the termination and a note that services will be continued for 30 days, to allow the patient to find another doctor…..”

Personally, I send certified AND regular mail, with the usual return service and address service requested, but regular mail to last known address of record is adequate, at least in my state.

NO. YOU. DON’T need to provide a “detailed explanation”.

“…..Statements like “I cannot provide effective care for you” should be avoided……”

I don’t provide ANY explanation.

At least they got the 30 days and offer to transfer records right.

Now hey, there may be differences from state to state, but I’m following the directions of my state medical association medico-legal department. There may also be restrictions due to insurance contracts you may have signed.

Personally I find putting reasons on the letter to be nothing but inflammatory. As though there can be a debate that they can “win” and I have to take them back. If I find a patient is trouble for any reason…..drug-seeking, manipulative, obnoxious, not paying, etc……..I send them a letter with the usual 30-day notice, and that’s it.

The only exceptions could be discharging because of a protected status or if there is some sort of ongoing acute care. Management of chronic problems does not count.

And yet my office remains full….

Of course the patients know bloody well why I’m discharging them. I just don’t find a need to put it in writing.

If the drug-seeking patient tells other drug-seekers not to come to me, that’s just fine with me.

I guess I just make up for it by taking good care of the good patients because I don’t waste time and goodwill on the bad apples.

The result is the patients continue to see me as out-of-network even when their insurance changes to one I don’t participate with. One businessman called to make sure he knew which insurances I worked with, to make sure he offered himself and his employees insurances that allowed them to continue seeing me.

Life’s too short to put up with jerks like 6:16

I’ll give him credit, though, for recognizing that I was right and the “journalist” wrong on the facts.