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Docs to Disruptive Patients: 'You're Fired'

Joe Cantlupe, for HealthLeaders Media, August 15, 2013

"If there is acting out or threatening behavior, or if an allegation of threats is made over the phone, there is good reason to fire the patient," Whitehead says, referring to any healthcare facility. "If there are threats in person, 911 must be called."

While hospitals may have security staff, that's rarely the case for physicians. In July 2011, a psychiatrist in McLean, VA, had lunch with a friend, another psychiatrist, and expressed his concern about one of his patients, whom he said was getting paranoid and blaming all her problems on the doctor.

If that was the case, she should see someone else, his friend recalled. The doctor agreed, but the dismissal of the patient came too late: the next day he was shot dead by the 62-year-old woman, who later turned the gun on herself. That doctor didn't have a chance to fire the patient.

Second-guessing a patient's motives might not be wise, Whitehead says.

Sure, some physicians may feel a patient "didn't mean what they said, and feel I'm going to give them a second chance." That would be a mistake, she says.

"I don't think there's a second chance in this world because people carry guns."


Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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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.