Doctors "firing" patients

Super_RN, BSN, RN · Aug 3, 2005

Don't know if it is common, but it happens. Would you want a patient under your care that was not compliant? I sure wouldn't! The doctors where I work send a letter to the patient, informing them of the fact that they will no longer be taking care of them and state the reasons why. I cannot remember off the top of my head the name of letter...shoot!

:Melody: Jaime

Editorial Team / Admin · Aug 3, 2005

i had never known this could be done before. i've been up on my floor for 1.5 months or so, and seen 2 patients who were fired by their doctors. first one i don't remember the details, really, but one today....his cardiologist fired him (gave him 4 weeks notice) for chronic noncompliance. (39y.o., coke addict, 2 past mi's).
i never knew this could happen. another nurse said they can do that, but if he becomes inpatient, htey have to see him even if he's fired, b/c this is not a private hospital, but they don't have to see him in the office if they don't want to. this is a large hospital, we have 2 cardiology groups, so its not like there are no other cardiologists to see him.
anyways, is this common?

yes, this common, but, unfortunate,

i am a nurse practitioner and i have fired a couple myself. the way that you saw it done is correct, too. give the patient "notice" and tell them they will need to find another provider. however, if they present to the hospital and

you, the provider is on, you, the provider will have to take them as a patient. thie firing really applied to me in the clinical setting.

there is a fine line called abandonment that must not be crossed.

siri, crnp, clnc, rlnc

Vailgang · Aug 3, 2005

I have to admit that I had never heard of a doctor firing the patient but when I worked in the office I learned it. It depends on the type of practice and the doctor if it happens more frequently or not. I have to admit that I have encouraged the firing of a few patients.

Jill

nursejoey05 · Aug 3, 2005

:angryfire :angryfire We had the same doc for all of our family. He was wonderful. My husband is terminally ill, and this doc was the reason my husband is still alive. We owed a little money (not much--few hundred) and doc frequently told us not to worry about it. You know--husband terminally ill and on disability. Wife unemployed while going to nursing school, gazillions of dollars in debt from all these medical bills. No problem. Made me get a CT at the hospital once because he was convinced that I had kidney stones. I resisted because I couldn't afford it. He said "Don't worry about it. The hospital will write it off. They tell us docs all the time that they inflate prices so that some people's procedures are able to be written off." Had an incident with another doc who handled our bill in a very unprofessional way (forgot to tell us that EPO shots would cost us a few grand q2weeks co-insurance and then tells us that he can't provide them anymore because we can't pay--really upset my husband) Anyway our doc was furious with him for treating us this way. So we have this great relationship with our doc, see him on a Friday (usual friendly visit), receive a certified letter Monday stating that the whole family is fired effective immediately, 30 emergency care only, NO Reason. :angryfire :angryfire I tried to contact him, of course he wouldn't speak to me. Then they sued us for the money :angryfire :angryfire :angryfire He's the kind of doc that you see everywhere (grocery, hardware store). I don't know what I'll do when I see him. Plus I worry about seeing him at clinicals. I don't know if I'm that good of a person. The part that infuriates me is that he KNEW very good and well what firing us would do to my husband and me. It stunned us and made us sick. Plus anything could have been worked out. Didn't even give us a chance. Took us about 6 weeks to find a new doctor and of course we have to break him in. Little things like fever 100+ is potentially life threatening, etc. One of my husband's specialists covered writing the meds for us (he was in the same group as our doc and stunned like we were) Oh, I forgot that my husband had just gotten out of the hospital from a 5 day stay with pneumonia when he was fired. Then a week later I had to take him to the ER because he had pneumonia again, and the ER doc was FURIOUS about the way we were disposed of. She even made calls to try to find us a new doc. Our new pediatrician was stunned. I hate having to tell new providers this stuff, but they ask point blank why would you switch docs in your condition. Our pharmacist was stunned. My husband is on major doses of hardcore schedule 2 drugs and has been for a long time. And in my daughter's case, he had been her doc since she was born 5 years ago. I try to be tactful and only tell the truth. I always tell how good our relationship was and that he was a main reason that husband is still alive. Told you this was long and angry. But I need to get all this ranting out before I run into him at the hospital. :angryfire :angryfire jerk! This is the "other side" of the story. We were not non-compliant. We were not trouble makers. My husband obviously is very ill, but doc always wanted to be paged if something new happened, etc. I still don't understand. Except that his wife was the office manager. Either she thought she needed the money or she thought I was too cute. (So this is who pages you all the time :argue: :banghead: ) Sorry, had to find something to laugh about after having all this anger resurface! Thanks for listening. Sorry the subject was brought up. I forgot to mention that this doc was my biggest fan about going to nursing school. He said I would make a great nurse, that there ought to be a way for me to test out of somethings due to life experience (because I've had to learn to do so much) AND he was going to hire me when I completed the program! :angryfire

Editorial Team / Admin · Aug 3, 2005

I am toatlly dumbfounded, blown away, flabbargasted, and ashamed of this physician.

I posted that I had fired a patient(s), but, NEVER under circumstances such as you described and NEVER a whole family.

You definitely need to clear the air on this situation. Not sure how you would do it. But, bringing it up and/or treating this physician with contempt during your student clinicals is not professional. You need to confront him...... get him to face you "man (woman) to man".

I am so sorry for what happened.

Siri

Vailgang · Aug 3, 2005

Wow what a story. I can completely understand how you feel. I would want to rip into him also BUT....if you ever run into him I would probably just politely say "I accept your decision to no longer care for my family but could you please give me the rationale behind your decision?" And leave it at that. If you are sure that you will run into him I would wait for the right time and ask him. As far as seeing you on the floor doing clinicals...He should be professional. I would not persue a conversation at clinicals as this would look bad for you.

Good luck on everything.

Jill

nursejoey05 · Aug 3, 2005

My husband says that there is nobody on earth like me, and when I do run into doc, he knows I'll handle it with extreme professionalism. Knowing that it might possibly hurt my nursing career is the only reason I didn't file about 27 complaints against him. And knowing that I'll eventually run into him at the hospital. I firmly believe that he shouldn't have gotten away with this. It's like: if he could do this to us, patients that he clearly liked and wanted to help, how does he treat the ones he doesn't like? That shouldn't be allowed. Plus that "first do no harm" thing!

moonchild20002000 · Aug 3, 2005

I'm so sorry this happened to your family. I am just shocked that you could be treated this way. I agree with the OP, I would confront him in a professional manner when you see him at the hospital.

rambisisking · Aug 3, 2005

my first thought was ... what on earth would be a good reason to fire a patient. I could think of only a few...they became physically violent, they threatened you or your family or your staff, It's hard to think of more. I have heard the word non-compliance mentioned, Can you imagine a nurse firing a patient for not listening. Please tell me what is a good reason to drop a patient from your care, There must be reasons that would make sense, I hope. There is just something about the very sound of it that brings up the word WRONG in my head.

medsurgnurse, RN · Aug 3, 2005

My heart just broke reading this. I'm sorry this happened to you. It would be appropriate for you to expect an explanation of why they fired your family. My first thought was that he didn't actually do the firing, that it was his office manager or billing manager.

Editorial Team / Admin · Aug 3, 2005

my first thought was ... what on earth would be a good reason to fire a patient. i could think of only a few...they became physically violent, they threatened you or your family or your staff, it's hard to think of more. i have heard the word non-compliance mentioned, can you imagine a nurse firing a patient for not listening. please tell me what is a good reason to drop a patient from your care, there must be reasons that would make sense, i hope. there is just something about the very sound of it that brings up the word wrong in my head.

thing like: 1. stealing prescription pads and forging names, drugs, etc. 2. altering prescriptions after discharge. 3. continuously using illegal substances while in the hospital.

siri, crnp, clnc, rlnc