How Coordinated Care Can Ground Frequent Fliers

A number of these patients essentially have been "fired" by their primary care doctors for a host of reasons, such as missing too many appointments in succession, says R. Corey Waller, MD, a specialist in addiction and emergency medicine and director of the Spectrum Health Medical Group Center for Integrative Medicine, in Grand Rapids, Mich.

Waller spoke to me for an article  in May's HealthLeaders Media magazine that touched on the firing issue. Spectrum has targeted frequent fliers by steering them toward less expensive coordinated care.

When Waller uses the term "fired," he is referring to patients who are no longer welcome by doctors to have business with them. There has been much debate about "firing" patients, such as in pediatric cases when parents refuse vaccinations. It's a sensitive issue.

Medical associations say that should only occur in certain situations, when patients are abusive, or decline to pay bills, or yes, even when they continually miss appointments. In any event, patients should be given proper notification.