“I need to talk to YOU”, barked the elderly mother of my friend, Jane.
“ My Cardiologist FIRED ME! ” she exclaimed.
“ For being a non-compliant patient?” I queried.
“ How did YOU KNOW ? “ She demanded. My friend Jane gave me a knowing look. Hmm I thought, need to be diplomatic here. “ Well, that is the primary reason a doctor will terminate the patient/doctor relationship.” I tried to sound matter of fact.
“HMPH! She snorted…just because I don’t want to take all that diabetes and cholesterol medication he prescribed for me—I just don’t believe in it! It’s a conspiracy between the pharmaceutical companies and the doctors! Firing a patient–I never HEARD of such a thing!”
I sure have, I thought!
Nothing says high-risk, non-compliant patient like a cantankerous older, obese patient with several chronic conditions, who refuses to follow their prescribed medication regimen.
Many physicians find it difficult to terminate a long-term relationship with a patient. A physician has every right, in fact it is good loss prevention policy, to terminate your relationship with a non-compliant patient after you have exhausted every effort to manage their condition.
Kimberly Hathaway, MSN, RN, LHRM, CPHRM, CPHQ
Risk Manager for The Doctors Company, advises ” It is good practice to discuss issues related to keeping appointments, acceptable behavior or compliance with the prescribed treatment with the patient, prior to sending the patient a discharge letter. In very few instances should the letter be the first indication to the patient that things just aren’t working between you. Each situation is different, but a physician has the right, in fact it is good loss prevention policy, to terminate the relationship with a non-compliant or disruptive patient after you have exhausted other efforts to manage their behavior and or condition”.
Most brand name malpractice insurance companies have a Risk Management or Patient Safety consultant that can provide you with guidelines, resources and medic-legal advice, if you have a patient relationship that you feel you need to terminate. Take advantage of this resource so that you can protect yourself.