Anonymous wrote:I am a veterinarian. I fire clients when they are abusive to my staff. They get a copy of their records and a very polite notice stating we hope they can find a practice that better aligns with their standards and needs....They are given a list of practices in the area accepting new clients, along with a list of emergency clinics.

I totally get this. Clients bringing in pets are just insane with internet misinformation and the assumption that everything costs too much. They just don't get it that this all costs a lot of $$, the education and technology has progressed a lot in 15 years, and vets really are burnt out.

Signed,
Not a Vet, but a Pet Owner Who Has Seen a Lot of Abuse

What is the conversation like when a doctor is letting a patient go. Is it veiled as something else or is it explicitly stated?

And is Medicare a reason or not? I mean, doctors are paid less, so I can see that.

^^and the CYA aspect is largely, if not entirely, because of patients threatening lawsuits or actually filing lawsuits. To the person who suggested we would practice better medicine if we had a few lawsuits hanging over our head, you have no idea what you’re talking about. If I suspect a patient will be quick to sue me if they get sicker, I do not keep them as a patient. If I do keep them, for some reason, you better believe I’m ordering every single test known to man, even if the test probably exposes them to unnecessary radiation or gives them worrisome false positives. Because that’s the danger of overly defensive medicine- it actually causes more health problems than it solves, but hey, at least I won’t be getting sued.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am hearing this is becoming an issue. It seems a Dr can refuse to see a patient if the patient is deemed annoying (by asking questions) or for no reason at all.
Until recently I have never heard of this and I have heard this multiple times. In some cases the patient is on Medicare. How can this be suddenly happening?
Is it legal and what is the driving force?

OP I am not a doctor but a healthcare professional who works with a variety of patients.

I “fire” patients all the time for non-compliance. I am not there to validate their own perspective about their health. If they don’t agree with my approach and take action to implement I’m not interested in working with them.

Stop playing and come down off that cross!

The pp is correct. Doctors are autonomous professionals any are not required to take on any and everyone unless they are working in an ER.

A lawyer doesn’t have to take or keep your case, a contractor doesn’t have to do your job. Neither does a doctor if they think you can’t work productively together.

You’re not entitled to treat a professional poorly and still demand they serve you or do business with you. Perspectives may differ but unless you can prove it is discrimination against a protected class, you are free to find another doctor.

Deciding to not follow a doctor’s advice is not “treating them poorly.” They give advice; the patient decides whether to take it or not. The doctor is not the boss or God.

I personally would not keep seeing a doctor whose advice I frequently disagreed with, but we don’t know the whole situation. I’m guessing the “medical professional” here is a chiropractor or similar.

If I, as a doctor, prescribe a diagnostic workup and the patient disagrees with it and won’t complete it- yes, I will likely terminate the relationship. It is a huge liability to me to have a patient with, say, worsening chronic morning headaches who won’t get a head CT. (This is just one very simplified example- that’s never actually happened- but it’s the general idea). It also indicates that they don’t trust my judgment, which means I’m not going to be able to help them. So they’d do better going elsewhere which is fine. It’s not a punishment or an ego trip to decline to keep a patient on my panel. It’s CYA, and it’s also so neither of us is wasting the other persons time.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am hearing this is becoming an issue. It seems a Dr can refuse to see a patient if the patient is deemed annoying (by asking questions) or for no reason at all.
Until recently I have never heard of this and I have heard this multiple times. In some cases the patient is on Medicare. How can this be suddenly happening?
Is it legal and what is the driving force?

OP I am not a doctor but a healthcare professional who works with a variety of patients.

I “fire” patients all the time for non-compliance. I am not there to validate their own perspective about their health. If they don’t agree with my approach and take action to implement I’m not interested in working with them.

Stop playing and come down off that cross!

The pp is correct. Doctors are autonomous professionals any are not required to take on any and everyone unless they are working in an ER.

A lawyer doesn’t have to take or keep your case, a contractor doesn’t have to do your job. Neither does a doctor if they think you can’t work productively together.

You’re not entitled to treat a professional poorly and still demand they serve you or do business with you. Perspectives may differ but unless you can prove it is discrimination against a protected class, you are free to find another doctor.

Deciding to not follow a doctor’s advice is not “treating them poorly.” They give advice; the patient decides whether to take it or not. The doctor is not the boss or God.

I personally would not keep seeing a doctor whose advice I frequently disagreed with, but we don’t know the whole situation. I’m guessing the “medical professional” here is a chiropractor or similar.

Anonymous wrote:I think it is problematic when doctors are not open to polite questioning and they aren't receptive when you inform them that they were in fact wrong. Sadly sometimes the only way they are forced to truly accept they are not God and were wrong is through a lawsuit. I wouldn't be surprised if many lawsuits could be prevented by a doctor simply checking his/her ego at the door and admitting he/she doesn't know and needs to refer.

My cousin is dead. Her cocky internal medicine doctor and self-important GI doctor told her she had anything from IBS to gluten sensitivity to she just needed a good shrink and it was in her head. She dealt with endless rude speeches, ego meltdowns and belittling. She got fired from doctors or had to leave doctors and was desperate to find some one who could get over their ego and judgment and listen. Then she ended up violently ill in the ER and she was diagnosed with late stage ovarian cancer. It was a pretty miserable death. I don't know her if her husband ended up deciding to sue to rudest doctor. he did let him and his superiors know the mistake and there was no response. No remorse. No gratitude for the update so they are more attuned with the next patient.

Oh, that wouldn't be enough to make you happy, or even less belligerent.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am hearing this is becoming an issue. It seems a Dr can refuse to see a patient if the patient is deemed annoying (by asking questions) or for no reason at all.
Until recently I have never heard of this and I have heard this multiple times. In some cases the patient is on Medicare. How can this be suddenly happening?
Is it legal and what is the driving force?

OP I am not a doctor but a healthcare professional who works with a variety of patients.

I “fire” patients all the time for non-compliance. I am not there to validate their own perspective about their health. If they don’t agree with my approach and take action to implement I’m not interested in working with them.

Stop playing and come down off that cross!

The pp is correct. Doctors are autonomous professionals any are not required to take on any and everyone unless they are working in an ER.

A lawyer doesn’t have to take or keep your case, a contractor doesn’t have to do your job. Neither does a doctor if they think you can’t work productively together.

You’re not entitled to treat a professional poorly and still demand they serve you or do business with you. Perspectives may differ but unless you can prove it is discrimination against a protected class, you are free to find another doctor.

+100

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors really only fire patients for what they believe is a liability to their malpractice insurance. But I could see how questions could be seen as threatening by some doctors.

How is asking doctors questions about your care or prescribed medications threatening?

Questions about care is not threatening, but if the questions are because the patient is not trusting my prescribed treatment plan or diagnostic work up as appropriate, then that is not a therapeutic relationship that’s going to benefit them. “You have ordered an abdominal CT, might that not lead to cancer? Can you promise me it won’t lead to cancer?” is also tricky because no of course I can’t, I can just say that I believe the benefit of this tool outweighs the risk for you at this time. If the patient clearly disagrees, then that’s fine, but I’m not going to take on the liability of a patient who refuses my diagnostic work up or, who agrees to it but says they’re going to come after me if it leads to cancer. It’s not worth the headache. Find a doctor you trust and if that’s not me, I get it and that’s fine.

I got news for you. There are no patients who trust a Dr. and that includes your patients. They’re all verifying everything you tell them.
Every patient knows you’re not in it because you care because the odds are you don’t.

Believe me, the vast majority of doctors care. We are human. And god knows we could make the same amount with WAY less schooling and student debt if we had chosen to, because on average we are pretty smart or else we wouldn’t have been able to get into a decent residency. But with attitudes like yours, it makes it harder and harder for the good doctors who do care to want to stay in practice. Pretty much everyone I know wants out at the 20 year mark (so, before age 50) once debts are paid and retirement saved up. Because it’s so, so draining to try so hard to help people and be ridiculed and eye rolled.

+1. The clever doctor who encounters an antagonistic patient who has an axe to grind or chip on their shoulder about doctors and medicine and science in general, will play modest, humble and dumb, they will say “I don’t know enough to help you” and suggest the person find someone more knowledgeable.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am hearing this is becoming an issue. It seems a Dr can refuse to see a patient if the patient is deemed annoying (by asking questions) or for no reason at all.
Until recently I have never heard of this and I have heard this multiple times. In some cases the patient is on Medicare. How can this be suddenly happening?
Is it legal and what is the driving force?

OP I am not a doctor but a healthcare professional who works with a variety of patients.

I “fire” patients all the time for non-compliance. I am not there to validate their own perspective about their health. If they don’t agree with my approach and take action to implement I’m not interested in working with them.

Stop playing and come down off that cross!

The pp is correct. Doctors are autonomous professionals any are not required to take on any and everyone unless they are working in an ER.

A lawyer doesn’t have to take or keep your case, a contractor doesn’t have to do your job. Neither does a doctor if they think you can’t work productively together.

You’re not entitled to treat a professional poorly and still demand they serve you or do business with you. Perspectives may differ but unless you can prove it is discrimination against a protected class, you are free to find another doctor.

Anonymous wrote:

Anonymous wrote:I am hearing this is becoming an issue. It seems a Dr can refuse to see a patient if the patient is deemed annoying (by asking questions) or for no reason at all.
Until recently I have never heard of this and I have heard this multiple times. In some cases the patient is on Medicare. How can this be suddenly happening?
Is it legal and what is the driving force?

OP I am not a doctor but a healthcare professional who works with a variety of patients.

I “fire” patients all the time for non-compliance. I am not there to validate their own perspective about their health. If they don’t agree with my approach and take action to implement I’m not interested in working with them.

Stop playing and come down off that cross!

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors really only fire patients for what they believe is a liability to their malpractice insurance. But I could see how questions could be seen as threatening by some doctors.

How is asking doctors questions about your care or prescribed medications threatening?

Questions about care is not threatening, but if the questions are because the patient is not trusting my prescribed treatment plan or diagnostic work up as appropriate, then that is not a therapeutic relationship that’s going to benefit them. “You have ordered an abdominal CT, might that not lead to cancer? Can you promise me it won’t lead to cancer?” is also tricky because no of course I can’t, I can just say that I believe the benefit of this tool outweighs the risk for you at this time. If the patient clearly disagrees, then that’s fine, but I’m not going to take on the liability of a patient who refuses my diagnostic work up or, who agrees to it but says they’re going to come after me if it leads to cancer. It’s not worth the headache. Find a doctor you trust and if that’s not me, I get it and that’s fine.

I got news for you. There are no patients who trust a Dr. and that includes your patients. They’re all verifying everything you tell them.
Every patient knows you’re not in it because you care because the odds are you don’t.

I can’t imagine having this attitude. Your outlook on life generally must really suck.

Yes. My attitude on the entire medical profession sucks. I have experienced two major misdiagnosis, infections, misread, radiology reports, and experienced abrasive nursing care. It is my own research and common sense that saved my life.
When you have a life-threatening, chronic medical condition you are in “the system”. It’s like being a foster kid and you better believe you need to advocate for yourself.

Anonymous wrote:I am hearing this is becoming an issue. It seems a Dr can refuse to see a patient if the patient is deemed annoying (by asking questions) or for no reason at all.
Until recently I have never heard of this and I have heard this multiple times. In some cases the patient is on Medicare. How can this be suddenly happening?
Is it legal and what is the driving force?

OP I am not a doctor but a healthcare professional who works with a variety of patients.

I “fire” patients all the time for non-compliance. I am not there to validate their own perspective about their health. If they don’t agree with my approach and take action to implement I’m not interested in working with them.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors really only fire patients for what they believe is a liability to their malpractice insurance. But I could see how questions could be seen as threatening by some doctors.

How is asking doctors questions about your care or prescribed medications threatening?

Questions about care is not threatening, but if the questions are because the patient is not trusting my prescribed treatment plan or diagnostic work up as appropriate, then that is not a therapeutic relationship that’s going to benefit them. “You have ordered an abdominal CT, might that not lead to cancer? Can you promise me it won’t lead to cancer?” is also tricky because no of course I can’t, I can just say that I believe the benefit of this tool outweighs the risk for you at this time. If the patient clearly disagrees, then that’s fine, but I’m not going to take on the liability of a patient who refuses my diagnostic work up or, who agrees to it but says they’re going to come after me if it leads to cancer. It’s not worth the headache. Find a doctor you trust and if that’s not me, I get it and that’s fine.

I got news for you. There are no patients who trust a Dr. and that includes your patients. They’re all verifying everything you tell them.
Every patient knows you’re not in it because you care because the odds are you don’t.

I can’t imagine having this attitude. Your outlook on life generally must really suck.

DP, but lucky you. On a long enough timeline, you'll meet some doctors who will change your mind. Those of us with chronic conditions just get there faster because we see more doctors more often. The whole industry is shit, and while there may occasionally be decent people trying their best in it, the "no good cops" adage tends to hold true in US healthcare too.

Of course, the ableism of not being believed when we try to speak up about the problems, or being insulted or dismissed when we do our own research and ask to be heard as active participants in our care also adds to the suck of having any sort of disability in the first place. And yeah, over time, our outlook on life does tend to decline as a result.

Best of luck for your continued good health, that you may never experience what some of us have to live through.

First, I was responding to this complete BS: "I got news for you. There are no patients who trust a Dr. and that includes your patients. They’re all verifying everything you tell them.
Every patient knows you’re not in it because you care because the odds are you don’t[u]."

I have most certainly run into my fair share of bad doctors and doctors who are in it solely for the compensation. Some of my friends are exactly that way.

But to say that odds are skewed to doctors of that type is complete BS and a projection. I think you have a complete misunderstanding of what the medical profession is generally able to do. What exactly is so special about you in particular that warrants extreme amounts of time to solve your problems? That isn't how an economy works - we can't dedicate unending amounts of time of limited resources to singular individuals. So you work within that arrangement and paradigm or you go out and make a ton of money to create the exchange you want.

Also, to assume I have never experienced a chronic condition is also wrong. The difference is I don't expect miracles and I am also not going to show up to a 15 minute appointment with a stack of self-identified pubmed citations demanding they be read on the spot. That is a good way to get fired.

Speaking of projecting... where did I say I did any of those things? After waiting howeverlong for my typically-late provider, I want to gtfo as quickly as possible. I don't bring studies; I say "this is what I need" and have whitecoats look at me like I've said it in a foreign language, backwards, while standing on my head because who the eff do I think I am to question their authoritAY?!

I don't expect miracles. I don't even expect basic humanity anymore. I generally expect it to be a timesuck and an annoyance, at best, and I'm pleasantly surprised on occasion when I meet an MD who still moves like a human.

And your position of "if you were rich, you could buy better care" is ableist on its face. Disabilities interfere with our earning potential. That's one of the reasons we're seen as "less than".

I think it is problematic when doctors are not open to polite questioning and they aren't receptive when you inform them that they were in fact wrong. Sadly sometimes the only way they are forced to truly accept they are not God and were wrong is through a lawsuit. I wouldn't be surprised if many lawsuits could be prevented by a doctor simply checking his/her ego at the door and admitting he/she doesn't know and needs to refer.

My cousin is dead. Her cocky internal medicine doctor and self-important GI doctor told her she had anything from IBS to gluten sensitivity to she just needed a good shrink and it was in her head. She dealt with endless rude speeches, ego meltdowns and belittling. She got fired from doctors or had to leave doctors and was desperate to find some one who could get over their ego and judgment and listen. Then she ended up violently ill in the ER and she was diagnosed with late stage ovarian cancer. It was a pretty miserable death. I don't know her if her husband ended up deciding to sue to rudest doctor. he did let him and his superiors know the mistake and there was no response. No remorse. No gratitude for the update so they are more attuned with the next patient.

I work at an urgent care and maybe it’s the low expectations (like, I’m not going to solve your underlying chronic medical issues today, unfortunately, and all parties seem to know this fact) but I find the majority of my patients to be pleasant and appreciative of the short term, immediate problem-focused help that I can provide them. I think it also helps that all parties are aware that there is going to be somewhat of a wait to be seen so it doesn’t come as an unexpected surprise when you are seen an hour after you arrive. Also, any patients that I can just tell I’m not going to jive with- that’s also fine, it’s easy to be pleasant and professional in a 10-15 minute urgent care visit no matter who the patient is or how they are acting. Because I know this isn’t a patient I’m going to have to spend hours a week on, largely unpaid, for the foreseeable future despite their abrasiveness. It’s a short term relationship for both of us, and we both know it. Anyways, 10/10 recommend for any docs experiencing burnout in your current practice.