Physicians are expected to provide care to our patients for as long as they request it. There are, however, circumstances when a physician should terminate his or her relationship with a patient.
Thank you for this. We all need to be honest with ourselves when we need to double down or back out. This is why we have a healthcare team, none of us can do it all alone.
Before terminating a relationship with a patient make sure you are not violating the state statutes on patient abandonment. Not complying to the law can impact your license and pocketbook.
Having worked with children and adults with various mental health issues for 43 years, the idea that terminating people for not complying with treatment for diabetes, smoking and alcohol/drug use shows so little insight and concern that I'm wondering if the author is practicing in the smallest town in the world or with the wealthiest population. Yes, it's extremely difficult to continue to try to address issues that people seem uninterested in resolving, but with enough time, and enough empathy, and calls to others who are working with those people to try to effect change in environment or interventions, positive outcomes are possible. Maybe success looks like drinking less Mountain Dew, smoking less, drinking less, and maybe we just need to measure success in smaller increments. Depressed and hopeless people usually show up for medical appointments when desperate, but if they truly believe the doc cares about them, they'll show up for follow up.
I know a single mom who tends bar in a small West Texas town. Her six-year-old was terminated by her pediatrician in May 2020. The doc told Mom she refused to care for her daughter any more because Mom's employer, the bar owner, wasn't 'safety conscious' enough about Covid.
What had happened was, townspeople had largely shrugged off the brief state-mandated lockdown, ignored the county public health director's shelter-in-place order, and went about their business (and pleasure) - maskless I hardly need mention.
In fact, by summer 2020 in rural Texas, you could easily spot the physically or mentally ill in public, because they chose to self-identify with face coverings. It took til 2022 for most of the rest of the country to pick up on the trend.
I expect you saw this coming: The pediatrician who terminated the bartender's daughter was also the county public health director.
By May 2020 we already knew that kids were at much less risk from Covid than from influenza; that the 3% number sold to us as the IFR was actually just the CFR; and that 40 ct PCR tests yield over 90% false positives.
I actually think the pediatrician's decision was correct, from the 'affective neutrality' standpoint. Of course, a domineering sociopath like that really shouldn't have been caring for ANYONE's kids.
Typical doctor-patient relationship: doctor speaks, patient obeys. it's very hard to find a doctor who has the time and interest to properly care for a patient ... and those who do are impossibly over-subscribed.
After two years of NOT finding a med that worked for me, doc told me of a possible solution he had read about in the NEJM. BUT,, were this effort to fail, I would be referred out.
Maybe there should be an article on the reverse...patients who need to dump physicians who told them that the vaccine was harmless and safe. As a healthcare provider myself it was shameful that the entire medical profession was silenced and even part of this scheme to sell an experimental “vaccine” which will cause harm going forward....maybe we as i am now a patient too..we need to find providers who will be honest with US.
There is an incredible amount of arrogance in the medical profession these days. I was terminated by a doctor who had the audacity to write in an email as the reason: “the patient does not have confidence in my ability to treat him.” I never said I did not have confidence, I merely asked questions of him that required him to spend more than 30 seconds, and I reminded him that he was in fact earning money for that time, not doing me some kind of favor.
I’m really tired of doctors deciding they are not your doctor simply because it begins to require a little bit more effort than other patients. I have been tossed around from doctor to doctor for years on something that is destroying my quality of life, and I still haven’t really gotten any diagnosis due to my symptoms being “too complex”….
On another important note - I pay for this substack …. And it is one that argues for intelligent analysis of these topics. Is it too much to ask at this point that the writers do just ONE proofread to fix their blatant grammatical and spelling errors?!
I was reading an article telling patients they can now sue their doctors for abandoning them. This abandonment included not following up when the patient does not arrive for an appointment. I find this to be horrible precedent. A patient should take responsibility for their own care, it should not be the doctor's responsibility.
In the same vein, many physicians in my area will not take Medicaid. This is not because the physicians are that worried about the fact that Medicaid, if it pays them takes six months to reimburse. It is more due to the fact that the Medicaid patients tend to not show up for appointments and not follow their doctor's advice, therefore there is a lot more liability in taking on a Medicaid patient. As this article points out, terminating a patient is not always easy, and must be done with care. However, sometimes termination is necessary to limit the liability of keeping a patient who will not listen to you.
I was refused treatment by a "holistic" doc I had waited to see until I qualified for Medicare and could "afford" a visit. I focus on diet to keep healthy so told her I had an international background, ate a combination of cuisines, including Mediterranean, Indian, Iranian, and Japanese--all pretty healthy. I said I thought Iranian cuisine was the most medicinal in the world. This apparently was the wrong thing to say. I am mixed race and most of her questions were about my parents' racial backgrounds, over and over and over. She was known for her gifts of manipulation (medical, that is!) and she "manipulated" the bones of my torso. I have never been treated that violently by anyone, including as a kid in a fight with my rather bullying brothers. She told me she did this because "your stomach is stuck between bones of your rib-cage". I asked my chiropractor (who knew her) if that was possible. He doubted it. I wanted help re-balancing my post-menopausal hormones. She proceeded to make another appointment for blood draw. At the check-out I stated that I did not like the focus on profits that I saw in medical practices--I wasn't talking to her, just the staff. A few days later I got a letter refusing service saying we had "incompatible differences". She sent an identical letter by certified mail, which I refused to sign for. Her staff told me she would send suggested physicians I could see. But the only suggestions she had were the two major medical corporations that have bought up the local hospital systems. Her recommendations were off the Internet. I think she had a great deal of animus towards Iranians (which I am not) and racial minorities. I noticed everyone else in the office without exception wasn't just White but very blond. Later, when telling friends in my community (a good 60+ miles away but in the town where she lives) about the interaction without identifying her name or gender, several people immediately identified her by name! Apparently she increases her income (according to Manta this was only $40K --hard to believe) by charging 4X for an initial visit than for the regular visits. She is very focused on IV Vitamin C which insurance companies won't pay for and seems to target retirement age people, assuming they have more money and spend more on healthcare, and must pay for this treatment out of pocket which I assume from her stated income on Manta she does not report.
I have a problem with AMA "recommending" anything. Is there no legal means to at least sue a doctor who is engaging in racist or financial abuse? Not only did I pay way too much for this pathetic excuse for an intake interview but I also paid the insurance's premium. And what did I get from it? Absolutely nothing. This experience cost me approximately $600. I have not been to a doctor since, except for a "free" clinic that just wanted to give me drugs for issues that can be dealt with easily through diet and exercise and charged me another $400 for blood tests I did not agree to.
I don't use the healthcare system anymore. Never have used it much. But after those two experiences, forget it. Since COVID-19 when I immediately realized the official story was bunk (due to personal experiences--not an M.D. or scientist) I am appalled by how little integrity most doctors seem to have. They have been advising patients to take a shot they ought to know is harmful. If I knew, and I did not go to med school, why is it they don't? This is similar to vets who advise annual rabies shots which also cause vaccinosis. If you ask them what they do for their own animals, they'll tell you they take titers. You have to really push to get an answer at all. They don't give their own animals a rabies shot every year. They are required by law to advise you to harm your pets. How is that ethical? (Same thing with these pour-on flea collars.)
Is it legal to charge a patient for services if you then refuse to treat them because of your own racist biases? Does Medicare have any restrictions on this subject? One unhappy customer is equal to 100 happy ones, they say. This unhappy customer will tell anyone who listens what she observed of this shockingly racist doctor. I do not think the racism initially was focused on my actual racial background--but she seems to have been happy to use my parents' very brave and unusual marriage (at the time illegal) as an additional justification for the discrimination.
You write in very careful and caring language. That has not been my experience of doctors since I've moved into the realm of middle age (years ago). Granted doctors often discount what women tell them. When I asked my father's M.D. why he was on so many drugs he did not need, his answer was: "He was old; he was going to die anyway." I suspect it was Vioxx that killed him, although it could have been the Celebrex as well.
As I say, I've completely given up on the medical profession. I have twice the accuracy in diagnosing as the doctors I've seen through the years and the treatments I come up with are far more effective. And cheap. I could yammer on indefinitely about specific experiences but I won't bore you. Most people probably have their own stories. COVID-19 has acted as an X-ray of the healthcare industries. Why anyone would agree to any vaccine at this point is beyond me. And I certainly wouldn't take any medication requiring a doctor's prescription. There are alternatives in the natural world that are either free or close to free. And far more effective without all the harmful side effects.
My question is: Is there a way patients mistreated like this by doctors can report them to Medicare and will Medicare blacklist them?
“We are taught that physicians are caring professionals who look after our best interests.” Really? Maybe MDs are taught, or believe, that this is how they are seen. Patients often have a very different experience. Arrogant physicians who vastly overestimate their own knowledge base, speak down to patients more intelligent than themselves coupled with systems of auxiliary staff that seldom act in a caring way, is a better description of what many patients experience. The only terminations I’ve ever heard of are families being ousted from practices for refusing vaccinations. How that falls into any of the categories listed as reasonable causes is beyond me.
Medicine, especially is the US, is a profession that mostly draws people in search of prestige and a good income, not individuals with especially caring personalities wishing to do good. The result is as one would expect.
You can save yourself and loved ones from cancer via self-treatment using fenbendazole. Read the case reports here. Find your cancer of interest and see how it was eradicated with cheap, OTC, safe, readily available fenbendazole
What do you think about doctors dropping a patient when they refuse a vaccination or vaccines in general?
Thank you for this. We all need to be honest with ourselves when we need to double down or back out. This is why we have a healthcare team, none of us can do it all alone.
Amazing what those people get away with. They enter examination rooms unprepared...if a teacher did that!
They "wing it", because they're so unprepared.Five minutes up, and out the door they go. Ca-ching!
Before terminating a relationship with a patient make sure you are not violating the state statutes on patient abandonment. Not complying to the law can impact your license and pocketbook.
Having worked with children and adults with various mental health issues for 43 years, the idea that terminating people for not complying with treatment for diabetes, smoking and alcohol/drug use shows so little insight and concern that I'm wondering if the author is practicing in the smallest town in the world or with the wealthiest population. Yes, it's extremely difficult to continue to try to address issues that people seem uninterested in resolving, but with enough time, and enough empathy, and calls to others who are working with those people to try to effect change in environment or interventions, positive outcomes are possible. Maybe success looks like drinking less Mountain Dew, smoking less, drinking less, and maybe we just need to measure success in smaller increments. Depressed and hopeless people usually show up for medical appointments when desperate, but if they truly believe the doc cares about them, they'll show up for follow up.
I dumped my doc after I couldn't stop screaming in physical, and existintential pain. Another best decision I ever made.
I know a single mom who tends bar in a small West Texas town. Her six-year-old was terminated by her pediatrician in May 2020. The doc told Mom she refused to care for her daughter any more because Mom's employer, the bar owner, wasn't 'safety conscious' enough about Covid.
What had happened was, townspeople had largely shrugged off the brief state-mandated lockdown, ignored the county public health director's shelter-in-place order, and went about their business (and pleasure) - maskless I hardly need mention.
In fact, by summer 2020 in rural Texas, you could easily spot the physically or mentally ill in public, because they chose to self-identify with face coverings. It took til 2022 for most of the rest of the country to pick up on the trend.
I expect you saw this coming: The pediatrician who terminated the bartender's daughter was also the county public health director.
By May 2020 we already knew that kids were at much less risk from Covid than from influenza; that the 3% number sold to us as the IFR was actually just the CFR; and that 40 ct PCR tests yield over 90% false positives.
I actually think the pediatrician's decision was correct, from the 'affective neutrality' standpoint. Of course, a domineering sociopath like that really shouldn't have been caring for ANYONE's kids.
Typical doctor-patient relationship: doctor speaks, patient obeys. it's very hard to find a doctor who has the time and interest to properly care for a patient ... and those who do are impossibly over-subscribed.
After two years of NOT finding a med that worked for me, doc told me of a possible solution he had read about in the NEJM. BUT,, were this effort to fail, I would be referred out.
Maybe there should be an article on the reverse...patients who need to dump physicians who told them that the vaccine was harmless and safe. As a healthcare provider myself it was shameful that the entire medical profession was silenced and even part of this scheme to sell an experimental “vaccine” which will cause harm going forward....maybe we as i am now a patient too..we need to find providers who will be honest with US.
There is an incredible amount of arrogance in the medical profession these days. I was terminated by a doctor who had the audacity to write in an email as the reason: “the patient does not have confidence in my ability to treat him.” I never said I did not have confidence, I merely asked questions of him that required him to spend more than 30 seconds, and I reminded him that he was in fact earning money for that time, not doing me some kind of favor.
I’m really tired of doctors deciding they are not your doctor simply because it begins to require a little bit more effort than other patients. I have been tossed around from doctor to doctor for years on something that is destroying my quality of life, and I still haven’t really gotten any diagnosis due to my symptoms being “too complex”….
On another important note - I pay for this substack …. And it is one that argues for intelligent analysis of these topics. Is it too much to ask at this point that the writers do just ONE proofread to fix their blatant grammatical and spelling errors?!
I was reading an article telling patients they can now sue their doctors for abandoning them. This abandonment included not following up when the patient does not arrive for an appointment. I find this to be horrible precedent. A patient should take responsibility for their own care, it should not be the doctor's responsibility.
In the same vein, many physicians in my area will not take Medicaid. This is not because the physicians are that worried about the fact that Medicaid, if it pays them takes six months to reimburse. It is more due to the fact that the Medicaid patients tend to not show up for appointments and not follow their doctor's advice, therefore there is a lot more liability in taking on a Medicaid patient. As this article points out, terminating a patient is not always easy, and must be done with care. However, sometimes termination is necessary to limit the liability of keeping a patient who will not listen to you.
I was refused treatment by a "holistic" doc I had waited to see until I qualified for Medicare and could "afford" a visit. I focus on diet to keep healthy so told her I had an international background, ate a combination of cuisines, including Mediterranean, Indian, Iranian, and Japanese--all pretty healthy. I said I thought Iranian cuisine was the most medicinal in the world. This apparently was the wrong thing to say. I am mixed race and most of her questions were about my parents' racial backgrounds, over and over and over. She was known for her gifts of manipulation (medical, that is!) and she "manipulated" the bones of my torso. I have never been treated that violently by anyone, including as a kid in a fight with my rather bullying brothers. She told me she did this because "your stomach is stuck between bones of your rib-cage". I asked my chiropractor (who knew her) if that was possible. He doubted it. I wanted help re-balancing my post-menopausal hormones. She proceeded to make another appointment for blood draw. At the check-out I stated that I did not like the focus on profits that I saw in medical practices--I wasn't talking to her, just the staff. A few days later I got a letter refusing service saying we had "incompatible differences". She sent an identical letter by certified mail, which I refused to sign for. Her staff told me she would send suggested physicians I could see. But the only suggestions she had were the two major medical corporations that have bought up the local hospital systems. Her recommendations were off the Internet. I think she had a great deal of animus towards Iranians (which I am not) and racial minorities. I noticed everyone else in the office without exception wasn't just White but very blond. Later, when telling friends in my community (a good 60+ miles away but in the town where she lives) about the interaction without identifying her name or gender, several people immediately identified her by name! Apparently she increases her income (according to Manta this was only $40K --hard to believe) by charging 4X for an initial visit than for the regular visits. She is very focused on IV Vitamin C which insurance companies won't pay for and seems to target retirement age people, assuming they have more money and spend more on healthcare, and must pay for this treatment out of pocket which I assume from her stated income on Manta she does not report.
I have a problem with AMA "recommending" anything. Is there no legal means to at least sue a doctor who is engaging in racist or financial abuse? Not only did I pay way too much for this pathetic excuse for an intake interview but I also paid the insurance's premium. And what did I get from it? Absolutely nothing. This experience cost me approximately $600. I have not been to a doctor since, except for a "free" clinic that just wanted to give me drugs for issues that can be dealt with easily through diet and exercise and charged me another $400 for blood tests I did not agree to.
I don't use the healthcare system anymore. Never have used it much. But after those two experiences, forget it. Since COVID-19 when I immediately realized the official story was bunk (due to personal experiences--not an M.D. or scientist) I am appalled by how little integrity most doctors seem to have. They have been advising patients to take a shot they ought to know is harmful. If I knew, and I did not go to med school, why is it they don't? This is similar to vets who advise annual rabies shots which also cause vaccinosis. If you ask them what they do for their own animals, they'll tell you they take titers. You have to really push to get an answer at all. They don't give their own animals a rabies shot every year. They are required by law to advise you to harm your pets. How is that ethical? (Same thing with these pour-on flea collars.)
Is it legal to charge a patient for services if you then refuse to treat them because of your own racist biases? Does Medicare have any restrictions on this subject? One unhappy customer is equal to 100 happy ones, they say. This unhappy customer will tell anyone who listens what she observed of this shockingly racist doctor. I do not think the racism initially was focused on my actual racial background--but she seems to have been happy to use my parents' very brave and unusual marriage (at the time illegal) as an additional justification for the discrimination.
You write in very careful and caring language. That has not been my experience of doctors since I've moved into the realm of middle age (years ago). Granted doctors often discount what women tell them. When I asked my father's M.D. why he was on so many drugs he did not need, his answer was: "He was old; he was going to die anyway." I suspect it was Vioxx that killed him, although it could have been the Celebrex as well.
As I say, I've completely given up on the medical profession. I have twice the accuracy in diagnosing as the doctors I've seen through the years and the treatments I come up with are far more effective. And cheap. I could yammer on indefinitely about specific experiences but I won't bore you. Most people probably have their own stories. COVID-19 has acted as an X-ray of the healthcare industries. Why anyone would agree to any vaccine at this point is beyond me. And I certainly wouldn't take any medication requiring a doctor's prescription. There are alternatives in the natural world that are either free or close to free. And far more effective without all the harmful side effects.
My question is: Is there a way patients mistreated like this by doctors can report them to Medicare and will Medicare blacklist them?
“We are taught that physicians are caring professionals who look after our best interests.” Really? Maybe MDs are taught, or believe, that this is how they are seen. Patients often have a very different experience. Arrogant physicians who vastly overestimate their own knowledge base, speak down to patients more intelligent than themselves coupled with systems of auxiliary staff that seldom act in a caring way, is a better description of what many patients experience. The only terminations I’ve ever heard of are families being ousted from practices for refusing vaccinations. How that falls into any of the categories listed as reasonable causes is beyond me.
Medicine, especially is the US, is a profession that mostly draws people in search of prestige and a good income, not individuals with especially caring personalities wishing to do good. The result is as one would expect.
You can save yourself and loved ones from cancer via self-treatment using fenbendazole. Read the case reports here. Find your cancer of interest and see how it was eradicated with cheap, OTC, safe, readily available fenbendazole
https://fenbendazole.substack.com
In Canada if we set our doc free, we'd be without one (possibly for years).