I think their liability fears are very real. But it seems like there are ways of dealing with this, short of chucking the patient out the door.

In the matter of cancer screenings and other screenings and/or tests, reasonable people can disagree. In fact there’s quite a bit of evidence that the benefits of screening have been way oversold. And in any case, at the end of the day, *it is the patient’s right* to accept or decline.

I am afraid of surgery. My beloved grandmother died on the table and to this day the family doesn’t really know what happened. I’ve also had a close call with a wrong-site surgery. Does this mean I should be discharged from someone’s practice, just because I’ve grown resistant to the idea of having surgery?

There are times when nonadherence crosses the line, and then you just have to let the patient go. But firing patients without at least making some effort to find common ground is probably only going to create hard feelings. And then one of your unfortunate colleagues will be forced to deal with the fallout.