Docs to Disruptive Patients: 'You're Fired'

Joe Cantlupe, for HealthLeaders Media , August 15, 2013

A California physicians organization is finding that more doctors are dismissing patients because they are uncooperative, refuse to comply with treatment, exhibit drug-seeking behaviors, and increasingly threaten the safety of care providers.

Disruptive physicians get a lot of attention. Remember the story about the surgeon who feeling, "pushed beyond my limits" slammed down an incorrectly loaded device and accidently broke a surgical technician's finger?

Last week I wrote about toxic docs, but this week, I'm turning my attention to the disruptive patient in physician practices.

Years ago, physicians would be concerned about patients who consistently were late for appointments or simply didn't show up. Then, doctors would inform patients that they would be better off seeing someone else for care.

Essentially, the patients would be "fired." Those dismissals still go on, but most of the reasons have nothing to do with the calendar or schedule. Now, most terminations involve disruptive and threatening behavior often linked to drug abuse, says Ann Whitehead, RN, JD, the vice president of Risk Management and Patient Safety at The Cooperative of American Physicians.

Doctors own CAP, a California organization that assists physicians in risk management and other services, including dealing with disruptive patients.

See Also: Physicians Aren't the Only Problem

Doctors are dismissing patients because of "drug-seeking behavior, a request for multiple prescriptions, or a doctor identifying schedule 2 narcotics from different providers," Whitehead explains. "It's progressively getting worse, at least from looking at our call volumes. We also see more physicians being threatened than in the past."

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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.




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