Terminating the Doctor-Patient Relationship …

Inspired by this, I wrote the following. The first list is from the linked post, the second is my take. In the wake of recent #epicfail blogging by rheumatologists, I’m semi-amazed that this “how to terminate” thing got posted, although I’m only semi-amazed …

Grounds for Terminating the Physician–Patient Relationship

A successful physician–patient relationship must be based on mutual trust and effective communication. When these elements break down, it is likely in both parties’ interests to terminate the relationship. Common reasons for terminating the physician–patient relationship include:

• The patient fails to pay his/her bills.
• The patient continually cancels or misses appointments.
• The patient is rude, disruptive, uses improper language, exhibits violent behavior, or threatens the safety of the office staff or other patients.
• The office staff is uncomfortable working with or communicating with the patient.
• The patient is dissatisfied with the care he/she received from the physician.
• The patient requires more highly specialized services than the physician can provide.
• There is a conflict of interest between the patient and the physician (e.g., the physician’s religious beliefs preclude him/her from providing certain treatment options, or the physician has a personal or financial interest in the treatment option).
• The patient is habitually uncooperative and refuses to comply with the treatment plan.
• The patient fails to complete a series of treatments.
• The patient is unreasonably demanding.
• The patient did not provide an honest medical history or was misleading in the information he/she provided, thereby compromising the efficacy of treatment.
• The patient develops a personal interest in the physician. Examples include excessive contact with the physician, demanding the physician’s time in the absence of a legitimate or urgent medical need, or becoming angry or unreasonable when the physician is unavailable.
• The physician develops a personal interest in the patient. Examples include consultations that involved discussion of information not relevant to the patient’s treatment (e.g., details about the physician’s personal life), the physician becomes attracted to the patient, or the physician acted in a manner that would be deemed inappropriate by his/her colleagues.
• The patient filed a complaint or initiated a legal proceeding against the physician.

Grounds for Terminating the Physician–Patient Relationship (Patient Version)

A successful physician–patient relationship must be based on mutual trust and effective communication. When these elements break down, it is likely in both parties’ interests to terminate the relationship. Common reasons for terminating the physician–patient relationship include:

• The physician consistently fails to disclose the cost of treatment.
• The physician habitually leaves the patient lounging, in a gown, in a cold exam room, for thirty minutes or longer. Every damn time.
• The office staff behaves like a military guard in East Berlin in 1964: officious, unpleasant, and armed with strange weapons, including the ability to deny the patient access to her records.
• The office staff entertains itself by running the patient around in circles when trying to schedule appointments, get test results, renew prescriptions, or get phone access to clinical staff.
• The patient, after months/years of treatment, still feels like hammered whale shit.
• The patient requires more highly specialized services than the physician can provide. Like, say, kindness. Or actual help.
• There is a conflict of interest between the patient and the physician (e.g,, the physician is a paternalistic fuckweasel, and enjoys offering the patient hope, only to snatch it back because that treatment isn’t covered by the patient’s insurance).
• The patient is habitually uncooperative and refuses to comply with the treatment plan, because after months/years, IT STILL ISN’T WORKING.
• The patient fails to complete a series of treatments. Because that series keeps getting longer, changing, try-this, try-that, world without end, amen.
• The physician thinks the patient is unreasonably demanding. (“Bitch wants to be pain-free. As if.”)
• The physician believes that the patient did not provide an honest medical history or was misleading in the information he/she provided, thereby compromising the efficacy of treatment. (“Lying, drug-seeking bitch. For realz.”)
• The physician thinks that the patient has a personal interest in the physician. Delusions include perceived “excessive contact with the physician” (patient solely attempting to get an appointment sooner than 12 weeks out), demanding the physician’s time in the absence of a legitimate or urgent medical need (“because we all know bitch wants to be pain free”), or becoming angry or unreasonable when the physician is unavailable (“because bitch is still on that damn pain-free bus!”).
• The patient filed a complaint or initiated a legal proceeding against the physician, because bitch just wanted to be pain free but discovered she’d been given a medication that caused random side effects like anal bleeding and liver failure.