Just for some background......I work in an urban community health center in a relatively high crime area. Many of our patients have substance abuse issues coupled with other psychiatric issues. So today we had a meeting to review a couple of patients for discharge from the practice. One patient had stolen stationery and forged work excuse notes from another provider and myself. With almost no discussion it was decided to dismiss her from the practice. I agree with that decision, but then we discussed another patient who came to her appointment either high or psychotic, screamed, yelled, and phsyically and verbally threatened the provider, and had to be removed from the premises by security. Should be a no-brainer for discharge, but no......she gets to stay with barely a reprimand because she "is ill". The chair of this committee is a former social worker who doesn't have to deal with these patients, but absolutely refuses to consider the well being of staff, not to mention any potential liability if something happens to one of us. I'm all for helping people and being a "kinder, gentler" health center, but not at the expense of safety. Yes, I work here by choice and understand the population I deal with, but I think limits should be set about the kind of behavior that is tolerated. Not really looking for any advice, but needed to vent. Thanks for listening if you made it this far.