Firing your doctor carries emotional weight

Last week, a friend told me that her mother had been fired as a patient by her primary care physician in a letter she received in the mail. “Our philosophies of care are too different,” was the explanation.

Last week, I fired my oncologist by email. “I have transferred my care to ___ ___.” I gave no explanation, although the note was polite and appreciative.

My friend and I spent some time talking about how this “doctor firing” upset us. Both of us (she as her mom’s caregiver, me as an active patient) initially felt solely responsible when we saw signs that the relationship was not working out. We worried that we hadn’t figured out how to communicate with the physician and staff, that we weren’t listening carefully enough, that we expected too much.

We both wrestled with accepting that, in fact, this relationship needed to end. She accepted it after the fact, recalling years of feeling that the doctor and her staff were unresponsive and uninterested in working with the complex demands of the long-distance caregiving that she and her mom had patched together. I agonized before the fact: maybe my doctor was non-responsive because he thought I was second-guessing him or because I should have called instead of e-mailed.  Maybe he sees my queries as a waste of time: he really doesn’t think there is any intervention that might have an impact on my current disease.

My friend and I looked back on our experiences and agreed that, short of firing one’s doctor by just never showing up again (not recommended), formally ending that relationship carries significant emotional freight, whether we originate the change or our physician does.

Part of this is due to the sheer hassle of finding a new physician. Depending on where we live  and what kind of clinician we are looking for, it can be a daunting challenge to find any replacement, much less one with whom we feel we can work well. Active illness or the need for constant monitoring means that we may face a big gap in care if we haven’t prepared for the change.  This was the case with my friend’s mother, since it is not easy to find a clinician a) about whom useful qualitative information is available; b) who is taking new patients; c) takes our insurance; and d) seems compatible on the basis of available information or a single visit.

What also adds to our discomfort is the asymmetry of expertise between us and our clinicians. We patients can talk all we want about establishing partnerships with our doctors and how they possess medical knowledge but we possess unique knowledge about our own bodies, etc., but when the rubber hits the road, it’s their training and expertise that positions them as the sole gatekeepers who can provide access to the tools of health care that might ease our suffering and save our lives. It can be hard to walk away from those promises, even if staying with a clinician we dislike means we must hide our opinions and preferences or subject ourselves to disrespectful treatment by him or her and staff.

Is this just another one of those problems of the privileged? Perhaps. Many people simply don’t have a choice of the clinician who cares for them: they seek help from the nearest or the cheapest doctor. They see the clinician they are assigned to at the clinic or by their health plan.

But I also know the remarkable difference my relationship with my clinician makes in my own willingness to take on all the tasks of caring for myself. If I feel she has really listened to what is going on with me and what it is going to take for me to do what she recommends … if we together make a plan about next steps … if I trust her expertise and experience, I am much more likely to try to do my part. On the other hand, if I feel like she sees me as just the next problematic body part to appear on a fast-moving assembly line, if she is talking at me, not with me, if she interrupts, corrects me or ignores me, all bets are off. I’ll take her recommendations under advisement but do what I think is best.

Again and again, evidence points to our relationship with our clinicians as key to our effective participation in our health care. People are given facile advice by advocates, the media and the government to fire their doctor if they are dissatisfied with their care or communication style. I absolutely believe that we should try to find clinicians to care for us who are compatible with our personal preferences. But I also know that change is hard for all of us, especially when we don’t feel well, and that that the effort required to find the right clinician to replace the wrong one and the anxiety that such a move generates often outweighs the impulse and intent to make this change.

Patient-physician incompatibility is a barrier to our participation in our health and health care that has no direct policy solutions. Sure, the greater availability of clinicians – primary care providers in particular – would help. So, of course, would more qualitative and quantitative information about individual physicians (including robust patient ratings). But the bulk of the change will probably have to originate with us.  And it is likely that we will only take this task on when we learn how much more effectively we are able to care for ourselves when our efforts are in harmony with clinicians we like and trust and whom we feel are working with us to live as long and as well as we can.

Jessie Gruman is the founder and president, Center for Advancing Health. She is the author of Aftershock: What to Do When You or Someone you Love is Diagnosed with a Devastating Diagnosis. She blogs regularly on the Prepared Patient blog.

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  • Steven Reznick

    Having a patient leave your practice is as emotionally upsetting for the physician as for the patient. It is far less upsetting when it is openly discussed or communicated in my opinion. Unless you know there is a problem you have no chance of correcting it in this relationship or in any future patient doctor relationship. A short note that explains why you are leaving is very helpful.Leaving open the possibility of discussing why is even better. It goes both ways. I have dismissed patients who practice lifestyles that are in direct conflict with their health and most medical teachings. I have discharged patients who repeatedly do not keep appointments and do not call or email to tell you that they are not coming. I generally write them a note explaining why, give them a prolonged period to find a new physician so there is continuity of care and invite them to discuss the situation at a mutually convenient time if they so desire. I think this courtesy should go both ways .

  • Suzi Q 38

    I decided to leave my doctor’s care because:
    1. He doesn’t listen to my complaints when it is important regarding my medical condition.
    2. He gets defensive and does not seek ways to solve or help your health issue. i prefer a more “open” approach. “Let’s figure out what is wrong and what we can do about it, rather than” let’s wait and see.”
    3. He did not provide an email address; instead I had to email his nurse and rely on her to forward my message. He did not answer my email when it was very important.
    4. He does not explain things well. He does not go over all of your options.
    5. He treated me poorly if I wasn’t feeling well.
    6. In time, he did not believe I was sick.
    7. He did not write accurate notes about our visits.

    I fired him because I felt that if a doctor does not believe me, he can not help me. If he can not help me, why do I keep on seeing him?

    Eventually, he had to believe me when my my symptoms and tests proved my case. He was apologetic, contrite and embarrassed by his past actions with me. It was too late repair this physician/patient relationship. He was too embarrassed, and I was too angry.

    My returning to him would only serve as a living reminder of his stupidity as a physician. I could no longer trust him with my health care.
    I knew that for his own good, and mine, I had to move on so that we both could repair the damage he had done.

    Mistakes happen, but hopefully he has learned from his mistakes and my health problems.

    I have learned to not choose doctors solely on their credentials.

    • mw4165

      But, did you tell them why? One of the worst things about the medical industry is that MDs get little feedback from patients. When was the last time a Dr. you saw sent you an email survey asking why they hadn’t seen you in 2 years? Those patients who DON’T return are as important as those who do.

      • LIS92

        I had a issue with my doctor and before I fired her, I tried to communicate with her and work things out. When my only option was to pay for an appointment, I decided it wasn’t worth the money.

        • mw4165

          This is when you need to document, document, document. Send a letter to her manager (if in an HMO), or the BBB (if a sole proprietor), or her business partner. MDs NEED FEEDBACK!!!! How else will they know when they’ve done a good job? (And by “job” I don’t mean minimizing symptoms. An MDs job is MUCH broader than that.) Monetary/ compensation can only provide so much, and many MDs went into this profession because they wanted to help, only to be bastardized by the system.

          Providing feedback (both positive and negative) is a very important part of the process that has been destroyed by a 3rd party payment system.

          • LIS92

            I sent a letter to the doctor, not to fire her but to open a conversation to mend our relationship. She ignored me. I don’t see how an insurance company prevented her from making a 10 minute phone call to mend our relationship.

          • mw4165

            You need to look at the situation as “dog training”. Where were the incentives for the Dr. to call you back? There were none, right? If the only “compensation” MDs receive is monetary, they’ll shut down any situation that doesn’t “reward them”, just as a dog ignores your pleas to “sit” …unless you are holding a “cookie”.

            IMHO, this is the MAIN issue w/r/t feedback that encourages MDs to be business people rather than healers. They are only rewarded for activities that benefit pharmaceutical prescriptions, medical equipment, and other costly ventures. They are never rewarded for taking the time to learn who you are as an individual…as all their training comes down to randomized controlled trials, evidence based medicine, and adjusting to the “mean”. If you fall outside the “mean”, you become a problem as the supporting theory has no methods to describe how to treat your symptoms.

            Our medical system is broken…we can all agree on that!

          • Suzi Q 38

            This is what happened to me!
            I certainly know where you are coming from.
            I wanted to let him know that I was not doing well, medically. He “blew me off,” even though I reminded his nurse that I sent the letter and asked if he had received it. She responded and said via email that he did. When my heath condition deteriorated and I had to use a wheelchair for longer distances, it was found that I had good reason for my complaints…spinal stenosis in my c-spine.
            Yes, I could sue, but I realized that it takes a lot of effort and to do this. As I got better with time, I became less and less angry.
            Unfortunately, during my angry stage, I wrote a 25 page grievance that read like a novel.

            The Chief medical director wanted proof of the letter I sent him, which I had. I sent a copy of it to her.
            SHE apologized to me! She couldn’t believe it.

            When I was angry, I thought that I would also file a grievance with the state medical board. I realized later that while that may be comforting to me personally, it will not change my condition. Hopefully, the doctor is waiting for the other “shoe to drop,” which would be a service for a lawsuit.

            None will appear, because I have realized that he is younger (early 40′s) and maybe not as mature as I am. People my age (57) that are good people return emails and phone calls when it is important. I can only hope that he would know that I know that he was a liar and not very bright socially or business-wise.
            If you want the business and referrals, you are good to your customers.

            Now he may get an evaluation by me on Yelp, Vital whatever, or Health grades.

            Just because you can pass exams does not make you a good person. Sometimes doctors think that it is their duty to lie in the “face” of trouble. It just means too much for them.
            All I can say I was concerned for him when I had to turn over my “proof” (copies of the email letter outlining my concerns), but now I do not care. The Chief medical officer will give him a “slap on the hand,” but at least she knows what kind of person he is.

          • mw4165

            Use Yelp and any other online reference/referral tool. These are actually more powerful than writing to their manager, or to the Dr. It is about Feedback, both positive and negative…if you have a great Dr. make SURE you Yelp them too!!!!!

          • Suzi Q 38

            Are you a doctor? If you are, what a good attitude that you have.

          • mw4165

            Thx, but no.

            But, I hope to be educating doctors in the future as I am currently enrolled in a doctoral health care management program. And for the record, I do not blame Drs for the current situation. People do what they are incented to do. When there isn’t a good feedback loop, the MDs really have no where to turn for information other than their P&L. It is a sad situation, really.

      • EmilyAnon

        For me, to complain in person to a physician would be so intimidating. Who knows what words would blurt out in frustration that I might be sorry for later, with the possibility of both sides becoming defensive. But I would gladly reply to a survey type questionnaire, mailer or e-mail, where you could respond thoughtfully when you’re calm at home. If the doctor takes the initiative, the patient then knows their concerns are valued.

        • mw4165

          This assumes you want to remain under their care, right? Then, YES, managing your relationship becomes very tricky.

          Yelp and other online opportunities to critique your Dr may be a solution, but with the understanding that those who’ve been unhappy with care are much, much more likely to voice their opinion in an online format.

      • Suzi Q 38

        Yes, I did, in a 22 page grievance letter to patient advocacy. I just received an answer to my questions and concerns from the Chief Medical Officer of the teaching hospital. I have never done that before, and I am not sure that any good will come of it.

        I can say that I have recommended 20+ people since the 70′s when the mother of a friend died there of cancer.
        I was so touched by her treatment that I recommended everyone, including my sister and myself.
        Now I will not recommend them under any circumstances, and I tell my story when they ask why.

        • mw4165

          I tried to Up vote ya, but only the negative direction was working form my brouser :(

          One of the things I recommend is letting the Dr know you are “interviewing” them on the first appointment. They need to know they might be fired!!!

          Also, read “Pharmageddon” by Dr Healy. You need to know how MDs have been sandwiched between Evidence Based Medicine (Ha), Big Pharm, and the Insurance industry. They are in a VERY tough position!!!!

          • Suzi Q 38

            Thank you.
            I have just read Eric Topol’s book:” The Creative Destruction of Medicine.”
            I found this book very interesting and insightful, almost futuristic.
            I will order Dr. Healy’s book, thank you.

          • mw4165

            Yes, Eric’s work is GREAT!

            And as far as my school goes..I’m an older student with +20 years in strategic roles for +$1B companies, including pharmaceuticals. My work after I receive my doctorate will hopefully help MDs reclaim their ability to be healers, rather than treads on a pharmaceutical treadmill. I know it won’t be easy, but if we don’t fix this system, it will Bankrupt the US market, making the last Recession look like a cakewalk.

          • Suzi Q 38

            Thanks for your responses, they are refreshing.
            You actually think that doctors will care.

            I shouldn’t be such a “jaded” patient, LOL.

            I am sure that there are so many others that do care. There are a lot of good doctors, that do what is right within reason.

            That if I asked for help via email or complained about my symptoms, they would actually listen.

            I did have one doctor that did. He was my gastroenterologist, and he saved my mobility.
            My neurologist should have taken lessons from my gastroenterologist.

            I think that I will donate $1K in his name, rather than sue the other two for being such jerks.
            Alas, there is always “Yelp, Healthgrades, or Vital Signs.”

  • PollyPocket

    If the relationship has been dysfunctional, communicating the end of the relationship is easier said than done. I think most patients work very hard to try and fix issues before making a change.

    I have had the experience firing both patients and phycisians. As a patient, my care was mismanaged to the point where a sentinel event occurred and I required emergency surgery. The my physician never contacted me afterwards to check on the situation. But I am not about to lecture a senior physician and former chief of staff on his bedside manner.

  • anon3

    You medical professionals disgust me. You have relationships where unlike in real life, you hold all the power and can do what you want including getting rid of people who don’t comply with anything and everything you want and demand of them. Your job is to provide medical advice, assessment and save lives and improve quality of life. Your job is not to get angry at a patient who smokes or to look down on or speak down to or get rid of a patient who annoys you. You are being paid to give a medical service, not to control a person, and not to live in a bubble. Nobody should change doctors if that doctor isn’t listening or is rude. That doctor should not be a doctor, and should be replaced with one who has common decency, not inconvenience the patient or leave them without medical care, or tolerating sub-par care or good care from an obnoxious staff member. It is precisely upsetting for patients because they believe there is a relationship there, whereas the medical profession just sees the person as a bother and something they need to tolerate, and if they would only just do exactly what they were told… well they would be cured of everything! Such is the doctor’s arrogance over himself/herself and his/her entitlement to “fire” people they don’t get along with. Can you imagine shopkeepers doing something like that? Can you imagine if everyone had the power of doctors to get rid of people who don’t bow down to them? It would mean large sections of society would not get served anywhere as there are a lot of annoying, inconsiderate, rude and even abusive people. Doctors (and nurses and other medical staff) pick on the sick and the fact that someone can even consider a relationship breakdown a reason to leave is ridiculous. Either the patient has broken some law and should leave and hopefully not repeat it with someone else, or the staff member is not up to standard and needs reported for their failures.

    • Suzi Q 38

      Anon3,
      I understand your frustration and anger.
      I have been there.
      On the other hand, I have come to a “place” in all of this only to realize that not all doctors are bad. There are some very good ones.
      So now, my job is to point out the human errors that my doctors made so that they can learn from them, rather than ridicule or shame them.
      I also have to find a way to repay the doctor that did have the answer, and bravely stepped in to make sure that I had the proper care. I think that I will donate a little money to the hospital in his name.

      • anon3

        What is brave or admirable about doing the job that you spent at least 5 years training to do? And are being paid specifically to not not do? In other words, to do? You are full of gratitude in the same way a person would be for a parent who just didn’t beat them up every day. That is nothing to be proud of. Staff routinely ridicule and shame patients, including “firing” them when they have had enough, so why is it that you would not be comfortable giving the staff a taste of their own medicine and shaming and punishing them as they do with us? Most likely because you are still being brainwashed by someone into having low self-esteem and putting others above yourself for no apparent reason.

        • Suzi Q 38

          You can’t think for me.
          I am quite capable thank you.
          I have been angry. It is simply not worth it planning the punishment for them with glee everyday.

          I have already “gone after” a doctor that did not answer my emails when I needed him to.
          I had to show the medical officer proof. She couldn’t believe he did that until she saw my actual correspondence.

          Yes, I have shoved their noses in a few complaints, and I don’t need you to decide what I want to do or how I should feel about anything.

          The did not fire me. I fired them. This isn’t a “war” for me. This is a quest to make myself heard. As far as reporting them to the state board, well it probably won’t happen.

          Why? I have better things to do.
          On the other hand if the Chief medical officer has a bad attitude, then I may push a bit further, and tell her: “Oh you think that doctor did nothing wrong??? You’re joking. Let’s see what the state board says.” That would beat hiring legal counsel and expert physicians to prove the Chief Medical Officer wrong.

          She did apologize for the first doctor I complained about. I don’t know what else I could ask for….”blood?” No pun intended.

          I appreciated that she apologized.

          I am not brainwashed by anyone, least of all by you. My self-esteem is just fine. Others above myself?? Wow, aren’t you the novelist and one-minute “psychiatrist.”

          • anon3

            what?!!

  • mw4165

    Maybe for some it is emotional, for me it has made me feel powerful, involved, and RESPONSIBLE. Since Medicine has become a “pay for procedure” industry, there are NO INCENTIVES FOR MDs TO HEAL. As ObamaCARE becomes active MDs will be rewarded for end to end healing. “Pay for procedure” will become “pay for performance” – like 99.9% of all other industries.

    Welcome to the Real World MDs!

    • http://onhealthtech.blogspot.com Margalit Gur-Arie

      “like 99.9% of all industries”:
      like paying the grocery store to be satiated
      like paying the bar tender for being drunk
      like paying the clothes store for being warm or looking pretty
      like paying the electrician for being able to read at night
      like paying tuition for being smart
      etc. etc. etc.

      • mw4165

        LOL…I’m a retail strategist and professor in business, so I’d suggest you enroll in my marketing 101 course to learn what grocery stores, restaurants, fashion, and skilled technicians really do … and for those who pay the tuition to take my courses, they find out how SMART they already were through the application of new knowledge.

        • southerndoc1

          So when you go to a grocery store or restaurant, you only pay a fraction of the agreed upon price if you’re not pleased with the product or service (after consuming it)?

          • mw4165

            LOL. Nope. I take food back, often, or in the event the electrician hasn’t fixed the lighting issue, he/she doesn’t get paid until I’m satisfied. Grocery stores are in the business of SATISFYING the customer, how ever the customer defines it. Yes, I know there is a risk to sending things back at a restaurant, but I have NO issue with leaving no tip if the service has been bad. All of these behaviors give clear feedback to the service provider.

          • PCPMD

            And that’s totally fair, as long as that’s what you and the other party agree to up front.

            So I strongly urge you to tell your doctor what you’ll do if he or she doesn’t get the right diagnosis the 1st time, or satisfy you completely.

            Just warning you though … you might be in for a rude awakening.

          • mw4165

            Yes, I have had that rude awakening.

            Initially, it was shocking when I confronted the Dr with her malpractice (and the physical evidence that had been removed during surgery.). Did she offer to compensate me for the $20K surgery I needed to remove the surgical tool she left in my body? Nope.

            Did she show the slightest remorse, even when I stated I had no medical insurance as I was unemployed and therefore used my 401K to pay for the surgery, NOPE.

            All I wanted was an apology. (No I didn’t sue. In the CA market it wasn’t worth the $250K max I could receive, which has been the cap since 1976.)

            If she had been a contractor who made a similar ($20K) mistake on my home’s foundation, she would have ripped out all the concrete and re-done the work at a financial loss. That type of attention to customer satisfaction is what I’m talking about. Most other industries follow similar customer focused philosophies.

            THIS is my biggest issue with MDs — they take no responsibility for their mistakes and the system works to hide shoddy work. I don’t doubt EVERY MD reading this blog knows an other MD who should NOT be practicing, yet they continue to be protected. Think about what it takes to have your license revoked!

            Death in the hands of Medicine is the 4th leading cause of death in the US. Don’t you think something is wrong with this picture?

          • Suzi Q 38

            I feel so bad for you.
            What has happened to me is nothing compared to what has happened to you.
            I complained, because I knew it wasn’t worth it to sue in the state of California. Not all lawyers are willing to take on anything without a retainer these days.
            I wasn’t willing to put up the $10k or $20K retainer to sue the jerks and then lose on a statute technicality. Plus for me, I would have to prove negligence. While the second hospital neurologists told me that the first doctors and hospital waited too long to treat my dangerous nerve condition, it is hard to prove negligence. It is easy, to point out stupidity, though. I had to show proof of what I was complaining about, and even then, I doubt that they cared.
            Plus, the doctors probably will lie to protect each other.
            Did you at least complain to the California state medical board? If so, did that do any good?

            Also, I hope that what “comes around, goes around. ”

            When you get the energy, complain on the various medical rating sites, or Yelp.

            Also, you can write a few articles about your awful experience. At least the public may be warned about this doctor.

            Ask your lawyer first. I am going to check with mine. Some doctors deserve to be called out if they do not have the human decency to apologize.

          • mw4165

            PS I have GREAT relationships with my MDs, largely because I tell them that they will be my “medical consultant” and if they aren’t happy with that role, I’ll go elsewhere.

            I firmly believe that I am in charge of my health, not my MD. It is a powerful, motivating place to be and if more people felt like me, maybe there would be higher adherence to treatment plans.

            I’m really up front, in the event you hadn’t noticed, ;)

  • Bob

    Changing from old to new is somewhat like all old hiring and firing situations: in that was the hiring wrong causing the firing.
    Somehow the fact that all people change, patients and physicians alike, seems to be missed, as do all the factors concerning any relationship as well as impending changes in all associated areas, i.e. ObamaCare.
    Imagine if you will, an Oncologist, who for decades “lost” all his patients, or an Ob/GYN whose every case is the same basically for him but he has to treat all of them as “special”. My cardiologist “fired” me, because he didn’t like a computer being put between him and his patients and I suspect his vast knowledge led his life to become more interesting and he now spends more time with his kids before they are gone out of his house. I’m so happy he fired me!
    Soon this will become unimportant as there are not enough to go around, so watch what you wish for and try to understand that physicians are people too, and probably feel the same way about you, but most importantly are probably in a position to help you find a more suitable replacement before you are “assigned”..

  • BabyDoc

    Reading this article and the comments from another article on this site give me the uneasy feeling that we are “at war” with our patients. There is this persistent, insidious distrust of physicians from patients. There is a climate of “the docs are out to get us” that is pervasive and saddening. I try very hard to give my patients my best, most compassionate care. Often holding hands, drying tears, staying late, coming in even when it is not my call and have found many times those same patients that I have extended myself the most for are the ones who have eviscerated me and my practice on media websites when they become upset by one, usually minor, situation. It is as if all the good will that has been built in that relationship is completely erased and they go on a mission to not just end the doctor/patient relationship but all out destroy the ability of this physician to continue to make a living for my family. I have had false claims made to the state medical board which were quickly resolved once I took time from patient care to refute the claim and provide the available evidence to do so. The result is that “wall of dispassion” I have gradually erected to protect me emotionally and professionally. When I find a patient who, in my opinion, starts to become confrontational, demanding and distrustful I feel it is in the best interests of my ability to take care of my family to end the relationship,

    • EmilyAnon

      This is one of the saddest comments on doctor/patient relationships I’ve read here. What led to your conclusion of “us vs.them” should be of great concern to patients.

    • Suzi Q 38

      I am sorry this has happened to you.
      I am a reasonable person with two doctors that did not care.
      I have had a bad attitude, but rightfully so.
      The doctor did not have to end the relationship, I did.

    • mw4165

      BabyDoc – This is because the system doesn’t build equity between the relationship of the Dr and Patient. The average “patient lifecycle” is four years, and in many specialties it is less than that. This doesn’t build the ability for either side to maintain trust.
      I feel for you! I was considering Med School until I spoke to a few MDs and learned (in the 1990s) how MDs were loosing their power to BigPharm and Insurance companies. (One even told me “Go to Business school as the MBAs make all the decisions in medicine.”)

      This distrust, that MDs have, enables Medical Product Industries to force you into treatment regimes that benefits their bottom-line profits. It is a very simple squeeze-play which, since the 1980s, has worked brilliantly to strip diagnosis and treatment power from MDs (and reduce their salaries) while increasing medical expenditures.

      And regarding how to help those bad online reviews…Have you called those patients and asked for a face to face meeting so you can “apologize”? This action will likely cause them to at the least soften their reviews.

      • BabyDoc

        Yes it is a sad situation as medicine is, in fact, my second career. I was previously a college professor. I have always been taught to consider what another person is going through, which , I feel has helped me become an empathetic physician. I just wish we as physicians can be granted the same benefit of the doubt instead of the immediate assumption that we are trying to “get one over” on a patient. I once had a patient come in to discuss her hormonal issues, however, she began to tearfully discuss the recent death of her son who had died unexpectedly in his 20′s. I held her hand and let her release her grief as much as she needed and gently steered her to addressing her true issue, her depression. You can imagine this placed me significantly behind on my schedule. When I was finally able to end that appointment, I went to the next patient, apologized for the delay and this next patient launched into the most vicious tirade about how “you doctors have no respect for people’s time, and how she was sick of us overbooking just to make more money and she would have walked out but she had a problem and didn’t want to have to wait to get an appointment somewhere else in town”. Now I couldn’t violate the first patient’s privacy and tell this second patient why I was behind on the schedule, I just said that I was very sorry but something had come up that delayed me. This same patient went on several websites and gave her version/assumption of the day, said “I blew off” her comments about her long wait etc.. I just can’t see how “apologizing” to someone that unreasonable is beneficial. For every 1 disgruntled patient like that I have about 9 that are very appreciative of the compassionate, personal care my practice provides, however, its that 1 patient that is the most vocal and destructive. As a mother and a wife myself, I have often taken time from my family for those 9/10 patients. My family has come to understand and those 9/10 are thankful. I am not sure if it is worth taking more time from either of those for that 1/10. Does this feed into and encourage negative behavior ?

    • Patricia

      This is a hard situation to talk about. I think part of it has to do with the expectations each party has of the other. And you as a doctor need to have boundaries. That way you would not feel as though you were personally hurt by some people who put out reviews on you. Also, responding to medical complaints should be viewed as part of doing business, not time away from patient care (my opinion).

      How about this~ come up with a proper survey to give to all your patients which they can fill out anonymously before they leave (and put in a slot somewhere) that gives you your reviews. That would be more accurate than some website. People do that online because there are really no ways to communicate with a doctor about complaints; sort of like with teachers. One doesn’t want her healthcare (or child’s well being in school) threatened.

    • Kara

      BabyDoc, I am in the process of finding a new PCP because the last one was erratic and inconsistent. He would probably describe himself as you do above; however, his actions caused unnecessary grief when I should have been focusing on my well-being. I gave him a second chance and he dropped the ball again. He also offered support he had no intention of delivering. Perhaps the situation you perceive as minor was not minor to your patient. Did you ask them? Would an apology have solved the minor situation? Why did your patient become (suddenly) confrontational, demanding and distrustful? You seem concerned with yourself…I am sure your patient is concerned with their needs. The doctor I am dealing
      with stalled the release of my medical records. Why should patients subject themselves to distrustful doctors? Yes, there is an emotional weight associated with firing your doctor…but the price of not firing one may be too high.

  • Kaya5255

    Firing a physician should not result in guilt.
    There is no “equality” between an health consumer and a physician. When the consumer strives for equality, they are generally discharged from the practice. Physicians, for the most part, find knowledgeable consumers threatening. They also don’t like to be told no by consumers.
    Firing a physician who does not meet a consumers expectations should be fired.

  • Patricia

    It makes sense that people will leave a physician’s practice or a physician might choose not to have a certain patient in theirs; I don’t see that as ‘firing’. I mean there were no applications and ‘hiring’ procedures to begin with.

    But I think if doctors are rude, rushed, make mistakes, they should expect bad reviews and people leaving. Unfortunately many people put up with this behavior because doctor’s complain: We don’t have time to *talk* to you, it’s not our fault. Or: Hey we’re human we make mistakes, we can’t admit it or you will sue us (which is virtually impossible by the way).

    Some doctors need to get real with how medical care is today. The patient shouldn’t pay the price for it, merely because the patient is paying a LOT for insurance, and their health is not something that should be short changed. Also patients are more knowledgeable today, and don’t revere doctors like people did in the past.

    I have one doctor who respects that I can work out dosages of my medicines (for anxiety and ADHD) and one who is shocked at the suggestion. Those types of meds are so personal and need to be adjusted and can be without a dr’s appt. (OF course heart meds etc are different). So, I really think that if a ‘partnership approach’ were taken, plus a dose of respect for the patient’s own abilities, this “firing” wouldn’t happen. Otherwise, who cares, move on.

  • Anthony D

    Seeing I go to a teaching hospital, don’t fire any of my doctors. Instead I just ask to be seen my another fellow.

    Actually, that’s only a few times when I didn’t like the fellows snotty ways on how he/she treated me. Then I had a few incompetent doctors as well in one specialty in the past and never saw them since!.

    After a while. Doctors are like a dime a dozen to me (no disrespect) because I see so many of them!

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