Can the doctor refuse to see a patient?

  1. I was in my clinicals today and I heard a doctor saying to the nurse " I explain why he should stop alcohol consumption ...etc" he does not listen and I don't want to deal with him anymore, I actually want to see patients who are willing to change.He also said "I am not God"." My question is, is it right to refuse to help a patient? Can they do that?
    Just curious,Thanks.
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    Joined: May '10; Posts: 972; Likes: 765
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  3. by   Sun0408
    Interesting question.. It is my understanding that a Dr can refuse to treat a pt. Now this is from a private practice Dr.s that already has a relationship with the pt and if the pt refuses to comply. I am not sure in a hospital setting with no primary Dr. I would think a Dr. in the ER couldn't refuse to treat a pt in an emergent situation tho.

    I am curious to see what others have to say..
  4. by   pinksugar
    They sure can. I have seen plenty of doctors refuse to keep treating continually non-compliant patients.
  5. by   HeartsOpenWide
    In the office setting yes. In the E.R. no. Not all doctors work in the hospital. If the doctor happens to be the one "on-call" and is the "hospitalist" then another situation he can not refuse.
  6. by   netglow
    Is it right? Well, the more you learn you'll find right/wrong isn't really the question most times. Yes docs can decide not to see a patient anymore. Most likely he was just blowing off steam, to other staff. He probably will not approach the patient in exactly the same manner -- however he might come close and will D/C the patient. Often there is a limit to what we can do. If the patient must participate in tx, but refuses, often times there are "limits" to what the doc/hospital can offer this person. This can be especially so in ETOH patients. Know that docs will often come to the nursing station and think out loud, and blow off steam to the nurses. As a student, just understand this and be a good listener - not necessarily the good time to debate.
  7. by   pedimac
    People vent all the time. It's difficult to work in a setting and you see the same people keep coming back. It would wear on your psychy if you kept teaching people over and over that what they are doing is slowly killing themselves. I've had some experience with this.

    Did he ever say, "I refuse to see this patient ever again?" Or was he simply venting his frustration with the patient not caring about himself enough to want to change?

    To answer your question, a physician has to accept a patient under their service. Physicians can also transfer patient's from their care to the care of another physician. Just think of hospital to hospital transfers, and ICU to IMU transfers. Remember, though, practice laws vary state to state.
  8. by   SWS RN
    In private practice, in the state of FLorida at least, a Doctor can refuse to continue treating non compliant patients. However, they must notify the patient and give ample warning time to find another doctor.

    I was married to a Doctor and over the years he did refuse to treat a few very non compliant and troubling patients.

    Unfortunately, many times it is those very patients that become a threaten law suits, etc when things don't turn out perfectly. Of course, it is the non compliance that causes the poor outcomes, but it is never percieved as that...

    Yes, they can and I feel probably should refuse to treat.
  9. by   Altra
    Quote from healthstar
    My question is, is it right to refuse to help a patient? Can they do that?
    I'm curious to know how you perceive that this physician is "refusing to help a patient".

    You don't say what setting this was in, whether hospital or outpatient, or whether this particular physician was the patient's primary/attending doc or a consult or what ... so it's hard to speculate further. But the bottom line is, we (physicians and nurses) offer treatment/services. If that patient does not wish to comply with the treatment offered, that is his/her right ... but the physician is under no obligation to continue to beat his/her head against the wall.
  10. by   MissSpectacular
    Absolutely, if it is in a private practice and the MD is the primary. Patient comes into an ER, then no.

    I have seen MDs refuse to continue treatment for patients that are consitently non-compliant. Just last week we had an MD notify a patient and his POA that he will no longer be seeing him (pt. is CHF and end-stage renal failure, noncompliant with fluid restrictions and everything else you can imagine.)
  11. by   Fribblet
    A doctor can refuse to see a patient in private practice, the hospital, and the ER, despite what other posters have stated.

    In the ER, if the patient is non-emergent, the physician can refuse to treat a patient after they have been given a medical screening. It happens all the time.

    In the hospital setting, if the patient is admitted, then there is an attending physician who has assumed responsibility for the patient. While patients have rights, they also have responsibilities. If the patient is non-compliant and uncooperative, the physician can discharge the patient and refuse to treat them further.

    If the patient has come through the ER and the ER doc thinks the patient warrants admission, a physician is not obligated to admit the patient.

    Doctors in private practice "fire" patients all the time.

    I'm sure many situations are more nuanced and that there are regulations and procedures surrounding an MD "firing" a patient, but I don't know much about all that.

    Back to the ER, which is something I know a smidge about, an ER doc cannot literally refuse to SEE the patient. A provider must determine if the patient has an emergent condition and a federal regulation known as EMTALA binds the physician (as well as their ethics, hopefully) to provide any care necessary to stabilize the patient. Beyond that, treatment is up to the physician...more or less.

    EMTALA is not quite as cut and dry as I made it sound (Although it is pretty straight-forward), but I'm not getting into all the details about it. If you're interested there's a bevy of info on the web.
  12. by   BrnEyedGirl
    One of the addiction docs in my town is a saint. He has to be the most patient man I have ever met and he truly cares about his pts. He does however have his limits,,,...Pt scheduled and no showed 32 times over the last 8 months. He's been admitted 8 times in the same 8 months and to the ER 25 times. He's refused to be admitted from the ER 15 times in the same 8 months. Now the hwy patrol brings him in after he ran into a parked car with a bac of 387 and he wants me to admit him,....not a chance!

    So yeah,...they can fire their patients.
  13. by   SlightlyMental_RN
    Yep, they sure can. We have a Do Not Admit list for our unit, as these patients are known as serial non-compliant PIA. And believe me, for them to get on that list, they have to behave pretty darn badly, as we see it all in chemical dependency detox/psych.
  14. by   sharpeimom
    about 20 years ago, we had a nearly full grown puppy, who was sweet, large and playful. he had great big heavy feet and when it was nearly midnight on thanksgiving night, his hind leg caught my nose. it bled heavily and really hurt. we went to the er and the oncall was a neighbor.

    we have several physician neighbors and this is a block party-type friendly neighborhood. one such family
    had a six-year-old son who had been urinating on all of our shrubs and trying to "write his name" on our sidewalks. his mom was aware of the problem and we were working together to solve it. the boy's dad
    (the oncall) thought we were all just picking on the boy.

    when he saw who his next patient was and that my cc was not life threatening, he absolutely refused to even evaluate me. i was tired, bleeding, in pain, it was late etc., so we just left. we live around the corner from the hospital and as we drove by a neighbor's house, we noticed their kitchen light was on and that he was
    sitting at the table reading. that neighbor/friend is a pediatrician and we stopped and apologized for the late hour. the kid had also urinated in their yard.

    he said, as i had thought, that my nose was broken and splinted it. we talked about the other neighbor's reaction and said they'd been subjected to his attitude too. it seemed so silly that we didn't pursue it later.