So he flouted the law all along, treated me with complete and utter disregard for my safety, botched the surgery and allowed a nasty little control freak nurse to dope me against my will, now HE IS FIRING ME, without even the courtesy to inform ME of his plan! I guess once you screw up the patient badly enough you can simply wash your hands of the whole mess by simply jotting a note to the referring entity!!!!
Well not so fast Dr. Here is the proper procedure for firing a patient... First you tell THEM! IT'S THE LAW! Anyway, I didn't know this. I thought that a cowardly communication from the doctor to my nurse practitioner was the way business was done. Can't have the patient find out that they were fired! Especially if it looks like the patient won't be coming back for more sub standard treatment anyway! This royally pissed me off! On top of everything else the man who ruined my life thinks that *I* am a lower life form unworthy of even this much communication!
How bad was it? I was super angry at the CRNA, a total idiot with delusions of grandeur. I was not so mad at my surgeon because *I* assumed that the reason the surgery was performed so badly was because I fought while under anesthesia, just like I have done every single time g/a has been administered in my long and injury prone life. I blamed the CRNA for the poor outcome of my surgery. However, once I discovered that the surgeon thought that his bad surgery was actually good, that my surgeon was perfectly happy to allow my tendons and nerves to continue to be shredded and damaged by his surgery, and all the rest of it, impugning my mental health, etc. now he was firing me without telling me? That's when I turned on him. Enough subterfuge is enough. Final straw. Here's the article...
by Adam Alpers, DO
Occasionally, you may encounter patients who you no longer wish to treat. Reasons for ending the physician-patient relationship may include chronic non-compliance, rudeness to office staff, or non-payment of bills. (Not applicable to me...)
While these patient behaviors can affect the interactive care-giving process, they may also identify patients with a propensity to file a claim against you. To help reduce the risk of a future claim, a physician may terminate or discharge a patient from the practice. (Finding out that the ARROGANT man who wrecked my hand and mental health was firing me, AND the way I found out CAUSED me to sue him! Oh yeah, he just cared so much that when I had a bad outcome, instead of helping, he fired me. He could care less, not when he performed the surgery and certainly not after. Complain and you are gone.)
There are, however, certain exceptions that apply to terminating a patient.
- You may not terminate your professional relationship for any discriminatory purpose or in violation of any laws or rules prohibiting discrimination such as the Americans with Disabilities Act.
- You also are not permitted to terminate a patient where you know, or reasonably should know, that no other healthcare provider is currently able to provide the patient the type of care or services that you are providing to the patient.
Reduce the risk of abandonment for the patient
Abandonment occurs when a physician suddenly terminates a patient relationship without giving the patient sufficient time to locate another practitioner.
A patient, however, may withdraw from a physician’s care at any time without notifying the physician.
- To reduce the risk of allegations of abandonment, it is recommended that you discuss with the patient in person the difficulties in the physician-patient relationship and your intention to discharge the patient from the practice. (emphasis mine)
- Be sure to document the discussion fully in the patient’s medical record, also noting the presence of any witnesses such as a patient’s family member or a member of your office staff. (What discussion? What medical record? No such thing exists or at least was given to me, except a letter he wrote to my NP, which was in the only part of my patient records I was given... letters to others! A copy of this is on the blog elsewhere.)
Write a formal discharge letter to the patient
You are required by law to notify the patient in writing of the termination. The letter must state that you will no longer provide care to the patient as of a date certain. The date certain must be at least 30 days from the date of the letter. You must also state in the letter that you will be available to provide emergency care or services, including provision of necessary prescriptions, during the 30 day notice period. (Why a patient would want emergency care from a physician who can't stand them is beyond me. I never got a formal discharge paper at all. My NP didn't get one either as he was already gone to another job by the time that the letter from my surgeon was sent. )
The discharge letter should also include:
- A description of any urgent medical problems the patient may have.
- An offer to forward copies of the patient’s medical records to the subsequent treating physician. (This is not a good idea... Really! Please see the letter from my surgeon to the second opinion Dr. As a patient you do not want this discussion to take place. Your guy will probably try to black ball you, if he/she is anything like mine.)
- The name and phone number of a local physician referral service or the local/state medical society to assist the patient in locating a physician who is accepting new patients.
The care of a patient is a mutual agreement and is in many ways a team between you, the provider, and the patient, but when that relationship is strained and you can no longer feel that you are able to provide quality care to the patient, at that point it is time to end that patient-provider interaction. Make sure you have attempted all you can do to help and when you realize there is no more to do, discharging the patient may be the only course of action.
This is all laughable isn't it? What team? I was the sub human underling and he was almighty God. My surgeon didn't provide quality care from the start, so what changed? What exactly did he do to help? Nothing but denigrate me and my concerns out of hand. Go read what he said about me and about the problems I had with the surgery, it's all here. Look at my x rays. Read what other surgeons have said about the problems I had. The relationship was strained because of HIS behavior and performance, NOT mine. I took exception to the whole nasty business, and I'm the bad guy? Then this final act of lawlessness on HIS part in not following the laws about how to fire a patient.