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Docs to Disruptive Patients: 'You're Fired'

Joe Cantlupe, for HealthLeaders Media, August 15, 2013

Some patients are tapping into the Internet and bringing in reams of documents, arguing against their care plan. Others aren't paying their bills, either. And increasingly, there are the drug issues, Whitehead says.

Under those circumstances, a physician is not required to continue treatment of these patients, but must take steps to get another physician for continuation of care, including alerting the patient about the risk of not continuing treatment, and giving the patient reasonable notice before care is discontinued.

Still, the drug issue has catapulted itself to be among the chief concerns of physicians who eventually seek to "fire" patients. While most patients seek legitimate prescriptions, others are demanding more drugs for their conditions, such as seeking pain relief. Physicians must straddle a fine line in patient care, as well as facing increasing scrutiny from law enforcement, particularly over prescriptions for opioids.

"We're sitting in the middle of a minefield," says Arnold Feldman, a pain management specialist who runs the Feldman Institute in Baton Rouge, LA.

"We have to treat in terms of ethics aligned with our oath as a professional. But we're reluctant to treat people with opioids. We won't give them to patients who look suspicious, or if they've smoked marijuana. They are banging on the door, looking for treatment."

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1 comments on "Docs to Disruptive Patients: 'You're Fired'"


Carolyn Sawyer (8/19/2013 at 11:15 AM)
I would never want to see a health care provider threatened, injured or worse from a disgrundled patient. At the same time, the way health care has evolved, there are a lot of good reasons patients are disgrundled by the care they receive. It is hard to connect with a physician in an office when the patients are handed a nursing assessment and expected to fill it out. After completing their own assessment, their physician talks while his/her eyes are glued to a computer screen. The care plan is not solely a physician's pervue, and if the patient disagrees they are labeled noncompliant. Not so. The care plan is created by concensus.Its time for physicians to realize they are providing their best advice to patients, it is up to the patient to decide what they will or will not do.