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  #1  
Old 04-02-2012, 03:52 AM
ambushed ambushed is offline
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"Patient Abandonment", the law, and refusal to refill prescriptions

My general physician very sadly died unexpectedly a few weeks ago (he was a great person as well as doctor and we had an excellent relationship). I have some chronic health problems but my condition has been and remains very stable with the medications that he prescribed me, and there's nothing challenging about my care or health needs. It's all pretty routine.

There are five other internists in the office group he was in, and the people I spoke with assured me both verbally over the phone and in a letter that they would be happy to reassign me to another of their group and keep me as a patient. All I had to do was choose, and everything would be fine.

After reviewing my options and reading ratings of the doctors from patients, I sent in a fax asking to choose a particular doctor if he had room for me and was willing to continue my medications. That was a Thursday. On Saturday, I received a rude and icily abrupt certified letter from the group throwing me out of the practice! No consultation, no discussion, no explanations, just immediate termination with extreme prejudice. The letter said that I could be seen only in an emergency and only for 30 days from that date (which period has not yet expired).

Curiously, the letter was not signed! Not by anyone. An office manager told me over the phone that it wasn't signed because it represented the entire group. However, I've learned online that an unsigned letter has no legal effect at all (see Is an unsigned letter legally binding? and A unsigned letter has legal binding no?)

So my first General Question is: Is it actually true in this case that, effectively, its as if the letter doesn't even exist? Or is it binding all the same?

My main concern is about prescriptions. They've stopped refilling any of my medications, even those I need on a daily basis to deal with some chronic conditions (diabetes, for example)! They haven't explicitly rejected the requests from the pharmacy; instead, the requests simply languish with no action taken.

Is that illegal, especially in light of the unsigned letter? Does it violate an AMA or other ethics code? They're all MDs, by the way, and this is in Michigan if that makes a difference. I've read about laws against "patient abandonment": does this qualify? What are my options? Does anyone have any recommendations on how best to proceed? I'm already seeking a new doctor, but that will take time...
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  #2  
Old 04-02-2012, 05:06 AM
bengangmo bengangmo is offline
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I'm not going to comment on the legality or otherwise, mostly because I simply don't know.

But in my experience, when nasty unsigned letters are received it's normally from some relatively low level person who never had any place writing such a letter in the first place.
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Old 04-02-2012, 05:55 AM
Rachellelogram Rachellelogram is offline
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Can you go there in person and ask them about it? The fact that the letter was unsigned doesn't sound like any doctor's office I've ever heard of. I see lots of documents that go between the insurance company I work at and various medical providers (none terminating service as such, but still). What you're describing sounds like a very unusual anomaly, so I'd recommend going in person today to clear up the issue. Unless they're not accepting new patients, I can't think of a reason for them to decline to assign you to another doc in the practice. So, go there in person and bring the letter they sent you, and ask them about it.

If they won't compromise and write you a month of refills for now, go to your regular pharmacy and talk to the head pharmacist on duty. Explain the situation. Depending on your state, the pharmacist may be able to authorize one refill of each drug while you search for a new doctor.
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Old 04-02-2012, 05:55 AM
VunderBob VunderBob is offline
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I smell a rat.

Make an appointment to see the doctor of your choice, and take the letter. Ask him/her to their face if the letter is legit, and if it is, why they're giving you the boot.

it could be legit, but also a mistake, or even a malicious prank. If it's legit, then demand a release on the spot, and walk out with your records. Then find another doctor.

Last second thought: are you a Medicaid patient?
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Old 04-02-2012, 06:27 AM
samclem samclem is online now
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Since this is a real-life situation involving both medical and legal questions, let's move from General Questions to IMHO.

samclem, Moderator
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  #6  
Old 04-02-2012, 07:02 AM
MsRobyn MsRobyn is offline
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I'm thinking it's an insurance issue, too, and what you were supposed to get was not what you got.

Even though it's a group practice, not all individual doctors accept the same insurance plans. Often, it's an individual choice; one doctor may not want to deal with the hassles of Joe's HMO, so he won't accept it even though others in the practice do. It's possible that the doctor you want to see won't accept your insurance plan, or may not be accepting new patients who have your insurance plan.

I'm also thinking you might have gotten the wrong form letter. Many clerical workers in doctor's offices aren't very well-trained or paid much more than minimum wage. The employee responsible for sending letters might have been told to send you letter x but sent letter y instead and whoever you spoke to didn't bother to investigate any further before she talked to you. I don't see this as a prank because the possible legal consequences are too great for the practice.

Ultimately, the decision to drop a patient as you were, at least according to the letter you got, is a serious matter that usually isn't taken lightly. It's usually reserved for deadbeats, people who refuse to comply with doctor's instructions, and people who are abusive to the staff and/or doctors. Assuming none of these apply to you, it's probably safe to assume incompetence rather than malice.

So what do you do? Despite what VunderBob said, don't bother the doctor over this. He probably won't know any more than you do because many group practices keep insurance and other financial information separate from patient records to maintain a firewall so that medical care can't be colored by insurance considerations. (For example, a doctor might be tempted to order more tests if the patient has good insurance; these tests might not be indicated for that condition or not ordered for patients with insurance that isn't as good.)

The person to talk to here is the practice manager. This person is the ultimate authority for the business end of the practice. Make an in-person appointment and show this person the letter, have her pull your records, and ask for specific reasons why you got this letter. Don't allow him/her to give you off-the-top-of-their-head answers; make sure his/her responses come from your records. In fact, you are within your rights to see the actual records, so don't be afraid to invoke this right. If this person can't or won't give you answers to your satisfaction, demand a records release and walk out of the building with your records right then and there. Follow this up with a signed letter, sent return-receipt, that says that you are leaving the practice, and why. This is something they need to know, and something you need to document to cover your ass.

Finally, ask yourself if this is a practice you really want to do business with. If their administrative staff is so sloppy that you got a patient termination letter by mistake, can you trust them to keep your other paperwork straight? A good bit of the doctor-patient relationship is really the relationship between the patient and the business office, and if that's not working, find a new practice.

Last edited by MsRobyn; 04-02-2012 at 07:03 AM..
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  #7  
Old 04-02-2012, 08:54 AM
VunderBob VunderBob is offline
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Quote:
Originally Posted by MsRobyn View Post
So what do you do? Despite what VunderBob said, don't bother the doctor over this. He probably won't know any more than you do because many group practices keep insurance and other financial information separate from patient records to maintain a firewall so that medical care can't be colored by insurance considerations.
My point was colored by the practice manager being the driving force behind this, and going over their head. The House of Vunder has been bitten twice in the past by corrupt practice managers pulling crap like this. One lost her job when we fought back by going over her head to the doc, who was clueless to the multiple situations she was orchestrating.

I will absolutely stand by my statement that should you decide to walk away, do it with your records in your hands.
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  #8  
Old 04-02-2012, 09:49 AM
MsRobyn MsRobyn is offline
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Quote:
Originally Posted by VunderBob View Post
My point was colored by the practice manager being the driving force behind this, and going over their head. The House of Vunder has been bitten twice in the past by corrupt practice managers pulling crap like this. One lost her job when we fought back by going over her head to the doc, who was clueless to the multiple situations she was orchestrating.

I will absolutely stand by my statement that should you decide to walk away, do it with your records in your hands.
Here's how I understood the situation:
  • ambushed's doctor dies suddenly.
  • ambushed is told verbally and in writing that the practice is able and willing to assign him to a new doctor within the practice.
  • ambushed, after doing some research, sends a fax to request a specific doctor. This is on Thursday.
  • ambushed receives a letter on Saturday, two days after making his request, terminating his relationship with the practice. The letter is unsigned, which is what prompted the OP's initial question.
  • ambushed called the office to inquire about the letter's legal validity, and was told by "an office manager" that the letter isn't signed because it reflects the position of the entire group.
  • The OP focuses on the lack of signature. There are no further details about why he might have gotten the letter in the first place.

My assumptions, based on my experience as both a medical office worker and as a patient, are as follows:
  • ambushed is really asking the wrong question. The first question should have been "Why did I get this letter?" not "Why is the letter not signed?" If he'd asked the former question, whoever he spoke to would have had to pull his records to be able to give him an answer. At that point, the problem would have been found and the situation remedied.
  • The "office manager" answered the question she was asked, which, since it's apparently office policy, she didn't have to research.
  • The answer the OP got wasn't the answer he was looking for, but then, he got the answer to the question he asked. He didn't give the "office manager" a reason to look into it further, so she didn't. She assumed that ambushed was supposed to get the letter.
  • The OP didn't follow up, he simply came here and posted.
  • Finally, these kinds of termination letters can have serious legal consequences for the practice, which is why they're generally saved for the most egregious offenders. They also have to be documented in the record.
  • Given the facts as they were presented in the OP, malice isn't really at the top of the list. Assuming it is a prank or some malicious act isn't really helpful here.

The reason why I suggested starting with an in-person meeting with the practice manager (who is probably a different person from the "office manager" the OP spoke to by phone; the practice manager is the "office manager"'s boss.) is because it's very clear that the real issue is the lack of communication. Making sure that the practice manager has the actual records in front of him/her, and making sure that this person addresses ambushed's questions based on information from those records will address the entire problem, which is why he got a termination letter, and whether he should have gotten it in the first place. At this point, the practice manager can either correct the mistake, or ambushed can walk out with his records, followed by the letter I suggested upthread. The reason you start with the practice manager is because this person is the guy in charge of the administrative side of the practice. He (usually) reports directly to the doctors. It's Chain of Command 101. Even if you have to go back and talk to the same "office manager", it's OK, just do so in person under the same terms I've already described. Give her a chance to make things right or at least explain why you got this letter with actual information that is specific to you, not an off-the-cuff answer given over the telephone.

If, on the other hand, the practice manager turns out to be a dildo, then take it to the doctors by sending a return-receipt letter addressed to each of them that lays out the entire situation, what you've already done to resolve it, and that you intend to terminate your relationship with their practice effective immediately because of your dissatisfaction with the way their practice is managed. Making an appointment to talk to one doctor doesn't accomplish anything, but sending a letter will get their attention, especially when it's a letter that has to be signed for, and one all of the doctors get. (Make sure you cc all of them, as well as the practice manager, if you send this.) You will get action, I can guarantee it.

What the OP also has to be made aware of is that being "fired" from a medical practice is a serious thing for him, too. Having that letter in your medical records (and you can bet there's a copy in there) sends a red flag to a new doctor (and his staff) that you are going to be difficult, either because you don't pay your bills or you're an asshole whose behavior is so egregious that you're not worth the trouble.

It's important to address why you got the letter in the first place. I cannot overemphasize this point. Fuck the lack of signature. Focus on why you got the letter in the first place.

Or there's a lot more information than what the OP is sharing.

Last edited by MsRobyn; 04-02-2012 at 09:52 AM..
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  #9  
Old 04-02-2012, 10:23 AM
Ca3799 Ca3799 is offline
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I have only seen a termination of relationship notice like that a few times in my nursing career and it was always instituted by the doctor who no longer wanted to see the patient, usually for serious non-compliance to the point the Doc would be worried about legal problems, or for having the feeling that the patient was argumentative, hostile or threatening and would no longer be welcome in the office.

Also, whenever a notice was sent terminating the relationship, it was usually sent certified mail, return receipt, so that there was proof the letter was received.

I have never seen a case where the relationship with a whole group was terminated because one Doc died and the other docs could not or did not want to absorb that Doc's patient load, and I suppose that is possible, but it seems unlikely to me. They spend a lot of time 'building their practices' and generally try to keep their customer/patients.

So, perhaps it is as simple as that- the other Doc's are already overly full. Have you had problems getting appointments there?

Have there been any 'incidents' you would care to relate?
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  #10  
Old 04-02-2012, 03:56 PM
psychobunny psychobunny is offline
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FWIW the pracice is obligated to take care of you for that 30 days until you find a new doctor which includes filling your maintenance medications.
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  #11  
Old 04-02-2012, 04:11 PM
jackdavinci jackdavinci is offline
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No advice but please come back and tell us what you found out or how the situation resolved.
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  #12  
Old 04-02-2012, 11:25 PM
PandaBear77 PandaBear77 is offline
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The only time I've seen people kicked out of a practice is if they are a complete asshole to the MD or staff, or they're busted violating their pain contract in some way, either by getting more narcotics on the side or failing a drug test.

Assuming you're not an asshole or a drug addict, you should physically go down there and very nicely ask them to 'splain. It sounds like a mistake to me.

Get your records while you're at it. You'll probably have to pay for copying, though.
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  #13  
Old 04-03-2012, 01:28 AM
ambushed ambushed is offline
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First, thank you all most kindly for your welcome replies! This thread is another fine example of The Dope at work.

Gird your grid for another typically lengthy ambushed post (sorry!).

In reply to bengangmo, rachelellogram, VunderBob and others who suspect the letter may have been inadvertent or unauthorized by a doctor, let me assure you that it was indeed entirely intentionally authorized by a specific doctor that I've just today learned has a reputation for general misanthropy and for making snap, knee-jerk decisions. Had I known that, I certainly would not have chosen him for my doctor, but alas, here I am.

I received two copies of the same unsigned letter, one via conventional mail and the other via certified mail with return receipt, precisely as my readings about patient termination laws from professional web sites (like the AMA) repeatedly advise doctors to do when terminating a patient. Also, the day after my fax (on Friday), I received a voice-mail message asking me to call the group's office manager. I could not call until the following Monday (after receiving the letters on Saturday), and when I did she confirmed the termination by the doctor I mentioned in my fax. After explaining why the letters were unsigned -- "it came from the entire group" (total BS in my view) -- she went on and on in empty, blame-denying officespeak, during the course of which she "explained" that the doctor in question said I "needed to see a specialist", which is utterly ludicrous BS given the fact that my condition was and continues to be stable and that I was merely in what I'd call routine medical maintenance. All I needed was my regular prescriptions to continue to be refilled and nothing more. Certainly no "specialist" was needed! But that "explanation", of course, was obviously just a bogus cover for whatever snap judgment he made. He didn't even tell her what kind of "specialist" I allegedly needed!

Now, I don't know how to convince you I'm not some kind of "problem patient", such as being non-compliant or abusive or drug-seeking or drug-abusing or unwilling or unable to pay or rude or psychologically unstable or whatever. If the doctor had bothered to review my medical records (something he almost certainly did not do, considering the extremely tight timing), he would have seen no such thing; not a single word of criticism or other negative remark from my previous doctor who was right there in the same office! But I do have a suspicion about what might well have prompted his knee-jerk reaction: One of my daily, routine medications that I've been taking for years and has been prescribed by several past physicians is a scheduled drug (which by the way is not a pain medication). And that's the only potential for such an immediate, unthinking rejection I can possibly imagine. But I'll wager that's just what set him off.

It's definitely not an insurance issue, either; I know that he accepts my insurance. And if it were simply that he had too many patients (something which is certainly plausible considering that the practice had to absorb any number of other patients of my deceased doctor), why not just say that? I'd even specifically mentioned in my fax that I'd understand if he had no room for me!

There was no mention in the letters of any reason for discharging me. Here is the content of the letter (the letterhead lists all the doctors in the practice, including my doctor who has passed):
Quote:
Originally Posted by Unnamed Doctor

I will no longer be able to serve as your physician.

If you require medical attention in the future please contact [county medical society]

I will be available to treat you on an emergency basis only until April 16, 2012. This will give you time to find a new physician. Enclosed is an authorization form that permits me to send your new physician a copy of you medical records. Please complete the form and return it to me.


Sincerely yours,

[NO SIGNATURE]
I have not sent in the form, because to do so would legally represent my tacit acceptance of my receipt of a legally binding letter -- even though it was unsigned and thus technically doesn't legally even exist (or so those links in my OP claim). I wish to make a point about his unconscionable behavior and leave its mark in his record. I have no desire to sue him, since attorney friends in the past have taught me well that no one ever wins a lawsuit. Furthermore, I doubt I can prove sufficient harm. However, I plan to report him to the state's medical board and see to it that he's chastised in some meaningful way. But if I act as if the letter was legally binding, I lose all such courses of action.

By the way, a doctor can much more easily reject a patient with whom he has no history, and I've never met the man. However, I have been seen by another doctor in that practice when the now-deceased doctor was unavailable (only later to learn at his funeral service that this unavailability was due to his stage-four cancer). And it is this second doctor who was sent my refill requests and who has still refused to act on them. Thus, the laws against patient abandonment are in full force and definitely apply in my case.

I'm already out of two daily medications. In two or three days, I will have run completely out of a total of 5 daily meds. I have spoken about this several times with my usual pharmacist, who over time became good friends with me and would certainly do all he legally could to help me. He has truly praiseworthy principles and a very strong ethical code, yet has agreed to very small refills of the most important daily meds twice now, but that's all I will ask. His hands are tied, and my own principles are just as rigorous as his: Friends must NEVER push, and I totally refuse to do so. He has, however, kindly offered to write up my medication history and his professional judgment about them and myself, which he writes demonstrates I am an exemplary patient.

I'll now go on to reply to individual posts and questions that were not addressed in this post. However, please note that my two main questions remain (about which I don't quite agree with moving this out of General Questions):

(1): Does the fact that the termination letter(s) were unsigned definitely mean they effectively don't exist, or not?

(2): Does the legal requirement for continuing care even from doctors who dismiss their patients definitely include refilling daily medications, or not?

(psychobunny's reply strikes me as extremely likely, but I can't find anything online that specifically covers continuing prescription rules.)

If anyone is interested, here are some links to various documents that discuss patient dismissal and abandonment in the U.S.
Can your doctor dismiss you from his/her practice legally?

Legal Advisor: Terminating the Doctor-Patient Relationships (Note that this is from Massachusetts, which may have different rules than Michigan. However, I can't find an equivalent Michigan document)

When a physician may refuse to treat a patient

AMA Code of Medical Ethics: Opinion 8.115 - Termination of the Physician-Patient Relationship (Far too brief to be of much value).

When the Patient-Physician Relationship Is Broken

Anyway, this whole business once again shows that I chose my username well, yes?!
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  #14  
Old 04-03-2012, 01:37 AM
drdrizzy13 drdrizzy13 is offline
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Are you on a lot of pain meds?
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Old 04-03-2012, 01:41 AM
ambushed ambushed is offline
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Quote:
Originally Posted by bengangmo View Post
I'm not going to comment on the legality or otherwise, mostly because I simply don't know.

But in my experience, when nasty unsigned letters are received it's normally from some relatively low level person who never had any place writing such a letter in the first place.
Well, as I explain in my second post, here, the letter(s) conform to what my online readings about how to terminate a patient recommend, with the possible exception of a complete lack of explanation (though some lawyers recommend deliberately leaving that out for legal reasons). I'm highly confident that this was exactly what the misanthropic doctor in question wanted done...
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Old 04-03-2012, 01:52 AM
ambushed ambushed is offline
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Originally Posted by rachelellogram View Post
Can you go there in person and ask them about it? The fact that the letter was unsigned doesn't sound like any doctor's office I've ever heard of. I see lots of documents that go between the insurance company I work at and various medical providers (none terminating service as such, but still). What you're describing sounds like a very unusual anomaly, so I'd recommend going in person today to clear up the issue. Unless they're not accepting new patients, I can't think of a reason for them to decline to assign you to another doc in the practice. So, go there in person and bring the letter they sent you, and ask them about it.

If they won't compromise and write you a month of refills for now, go to your regular pharmacy and talk to the head pharmacist on duty. Explain the situation. Depending on your state, the pharmacist may be able to authorize one refill of each drug while you search for a new doctor.
Thanks, rachelellogram, for your good suggestions. I'm very reluctant to go to the office in person until I learn more about the legalities involved to learn if I have some legal cause of action (although as I explained in my second post, I have no desire to sue, the threat of legal action can often get someone's attention!). I'm also a bit worried I might lose my cool when challenged by this misanthrope and make matters worse.

As for the pharmacy, I also explained here that I won't push them any farther, but I will very probably see if the county medical society will agree to refill them temporarily until I'm set up with a new doctor. I'm not so stupid as to jeopardize my health just to make a point -- no face-spiting for me!
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Old 04-03-2012, 01:59 AM
ambushed ambushed is offline
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Quote:
Originally Posted by VunderBob View Post
I smell a rat.

Make an appointment to see the doctor of your choice, and take the letter. Ask him/her to their face if the letter is legit, and if it is, why they're giving you the boot.

it could be legit, but also a mistake, or even a malicious prank. If it's legit, then demand a release on the spot, and walk out with your records. Then find another doctor.

Last second thought: are you a Medicaid patient?
Hi, Bob! I'm not on Medicaid, and as I explained elsewhere, I'm highly confident the letter was deliberately sent by the doctor in question. And as I wrote to rachelellogram above, I'm not ready yet to visit the office in person.

But I am extremely grateful for your advice to simply take my current file as is rather than request copies! For one thing, they've already kicked me out of the practice, so there's no reason to keep a copy of them. But also, I don't want this jerk to know who my new doctor is in case he feels vindictive enough to interfere with my new patient-doctor relationship.

Thanks!
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Old 04-03-2012, 02:24 AM
drdrizzy13 drdrizzy13 is offline
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Originally Posted by drdrizzy13 View Post
Are you on a lot of pain meds?

Just curious if this may have something to do with it?
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Old 04-03-2012, 02:30 AM
ambushed ambushed is offline
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Before responding further, I wish to thank you enormously, MsRobyn, for your wise and insightful comments!

Quote:
Originally Posted by MsRobyn View Post
I'm thinking it's an insurance issue, too, and what you were supposed to get was not what you got.

Even though it's a group practice, not all individual doctors accept the same insurance plans. Often, it's an individual choice; one doctor may not want to deal with the hassles of Joe's HMO, so he won't accept it even though others in the practice do. It's possible that the doctor you want to see won't accept your insurance plan, or may not be accepting new patients who have your insurance plan.

I'm also thinking you might have gotten the wrong form letter. Many clerical workers in doctor's offices aren't very well-trained or paid much more than minimum wage. The employee responsible for sending letters might have been told to send you letter x but sent letter y instead and whoever you spoke to didn't bother to investigate any further before she talked to you. I don't see this as a prank because the possible legal consequences are too great for the practice.
Please see my second post, MsRobyn, which responds to these matters, and can be found here. There were no insurance or capacity issues stated, which could have been easily done with no consequences. The termination was clearly intended by the doctor in question, though it is my strong suspicion that it was very far from cautiously considered -- the timing was far too tight for that.

Quote:
Originally Posted by MsRobyn View Post
Ultimately, the decision to drop a patient as you were, at least according to the letter you got, is a serious matter that usually isn't taken lightly. It's usually reserved for deadbeats, people who refuse to comply with doctor's instructions, and people who are abusive to the staff and/or doctors. Assuming none of these apply to you, it's probably safe to assume incompetence rather than malice.
Another option -- the explanation I favor -- is a hasty, knee-jerk decision that was reached in an instant by an impatient and/or overly busy doctor who failed to understand or consider the legal consequences of his actions (or just didn't care about them at the time).

Quote:
Originally Posted by MsRobyn View Post
So what do you do? Despite what VunderBob said, don't bother the doctor over this. He probably won't know any more than you do because many group practices keep insurance and other financial information separate from patient records to maintain a firewall so that medical care can't be colored by insurance considerations. (For example, a doctor might be tempted to order more tests if the patient has good insurance; these tests might not be indicated for that condition or not ordered for patients with insurance that isn't as good.)

The person to talk to here is the practice manager.
This is just who I spoke to over the phone...

Quote:
Originally Posted by MsRobyn View Post
This person is the ultimate authority for the business end of the practice. Make an in-person appointment and show this person the letter, have her pull your records, and ask for specific reasons why you got this letter. Don't allow him/her to give you off-the-top-of-their-head answers; make sure his/her responses come from your records. In fact, you are within your rights to see the actual records, so don't be afraid to invoke this right. If this person can't or won't give you answers to your satisfaction, demand a records release and walk out of the building with your records right then and there. Follow this up with a signed letter, sent return-receipt, that says that you are leaving the practice, and why. This is something they need to know, and something you need to document to cover your ass.
This is wonderful advice! And it seconds the fine records advice that VunderBob gave me, too. Thank you!

Quote:
Originally Posted by MsRobyn View Post
Finally, ask yourself if this is a practice you really want to do business with. If their administrative staff is so sloppy that you got a patient termination letter by mistake, can you trust them to keep your other paperwork straight? A good bit of the doctor-patient relationship is really the relationship between the patient and the business office, and if that's not working, find a new practice.
Oh, I entirely agree, and I'm in the process of doing exactly that. But as I elaborated elsewhere, I nevertheless want to see a letter of castigation from the state medical board in his records, if not more. I also want the public to know about this unconscionable act and the refusal to refill my necessary daily meds, but I might well face a threat of lawsuits myself if I say anything in public about this without ensuring that all the legal ducks are in order. Thus, I'm not going to just forget about this, even though as I said above I'm not going to put my health at risk in the process...
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Old 04-03-2012, 02:41 AM
Alice The Goon Alice The Goon is offline
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I don't know the answer to all of your questions, but I do know that in no way are you going to be able to go in there and demand your actual file. For one thing, most records are electronic these days, and even if there is a paper file, it's not your property, it's theirs. They are legally obligated to keep your records for several years after you were last seen. They do have to give you copies of most of your file, but not immediately on request. They legally have 30 days in my state in which to do so- I'm not sure if the time varies from state to state.

As for maintenance meds, urgent care? They should be able to give you Rxs at least once, and you should be able to get in with a new doctor by the time you need more.
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  #21  
Old 04-03-2012, 03:16 AM
ambushed ambushed is offline
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Originally Posted by MsRobyn View Post
...

... My assumptions, based on my experience as both a medical office worker and as a patient, are as follows:

ambushed is really asking the wrong question. The first question should have been "Why did I get this letter?" not "Why is the letter not signed?" If he'd asked the former question, whoever he spoke to would have had to pull his records to be able to give him an answer. At that point, the problem would have been found and the situation remedied.
I'm sorry, but that is a misreading of my OP. At no point did I ever ask "why" the letter was unsigned. Instead --- and this is extremely critical -- I asked if this unsigned letter has any legal standing whatsoever or whether, since it was unsigned, it's as if I never received such a letter! Why is the answer to that question so critical? Because if the letter is legally meaningless, he is acting unequivocally illegally to refuse to care for me and refill my medically mandatory prescriptions, and thus I have an extremely strong legal case against him and his practice! Therefore the signature or lack thereof is of extreme importance to me and my situation! It's not some trivial consideration!

I contend that the "Why did I get this letter?" question is of far less importance, since I have no desire to stay with that practice after I received such a letter anyway. Also, I was given an "explanation" over the phone, of "needing to see a specialist", although that's utterly bogus. Asking again and again is pointless, since they fabricated an "explanation" in order to get rid of me without providing me any reason I might be able to sue them for.

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Originally Posted by MsRobyn View Post
The "office manager" answered the question she was asked, which, since it's apparently office policy, she didn't have to research.
To clarify, I was never told the official title of the manager I spoke with, and I was not aware that there was any difference between "office manager" and "practice manager". Now that I'm aware of the distinction, there's very good reason to believe that the woman I spoke to was indeed the "practice manager". But verbal discussions don't matter legally anyway, and no reason was given in the letter, which is just one more reason to pursue this as illegal.

Quote:
Originally Posted by MsRobyn View Post
The answer the OP got wasn't the answer he was looking for, but then, he got the answer to the question he asked.
That's plainly false on all counts, and I don't understand your reasons for asserting that. The two questions that I actually asked in my OP have not yet been answered.

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Originally Posted by MsRobyn View Post
He didn't give the "office manager" a reason to look into it further, so she didn't. She assumed that ambushed was supposed to get the letter.
Again, incorrect on all counts.

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Originally Posted by MsRobyn View Post
The OP didn't follow up, he simply came here and posted.
What's that supposed to mean? I came here and read the responses and replied as soon as I could work it out. In case you expected me to act otherwise, please be aware that I don't use my employer's computers to deal with personal matters.

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Originally Posted by MsRobyn View Post
Finally, these kinds of termination letters can have serious legal consequences for the practice, which is why they're generally saved for the most egregious offenders...
Or, are issued by the most egregious and recklessly impulsive doctors, who in this case may well have falsely believed that I'd have no legal recourse because (as I discussed elsewhere) he and I had no history (even though another still-living doctor in the practice did).

...

Quote:
Originally Posted by MsRobyn View Post
...It's important to address why you got the letter in the first place. I cannot overemphasize this point. Fuck the lack of signature. Focus on why you got the letter in the first place.

Or there's a lot more information than what the OP is sharing.
C'mon now! How far into your medical TMI zone would you venture on a public message board? Please carefully read my post here and let me know what you think.
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  #22  
Old 04-03-2012, 03:22 AM
ambushed ambushed is offline
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Originally Posted by drdrizzy13 View Post
Quote:
Originally Posted by drdrizzy13 View Post
Are you on a lot of pain meds?
Just curious if this may have something to do with it?
Hi, drdrizzy13. That's a very reasonable question, but the answer is no. My previous doctors have prescribed occasional vicoprofen, but I use it so rarely that a thirty-day supply lasts 6-8 months. That's one of the things my pharmacist made clear in the letter he wrote for me, and any doctor can confirm that readily.
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  #23  
Old 04-03-2012, 03:29 AM
ambushed ambushed is offline
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Originally Posted by Alice The Goon View Post
I don't know the answer to all of your questions, but I do know that in no way are you going to be able to go in there and demand your actual file. For one thing, most records are electronic these days, and even if there is a paper file, it's not your property, it's theirs. They are legally obligated to keep your records for several years after you were last seen. They do have to give you copies of most of your file, but not immediately on request. They legally have 30 days in my state in which to do so- I'm not sure if the time varies from state to state.

As for maintenance meds, urgent care? They should be able to give you Rxs at least once, and you should be able to get in with a new doctor by the time you need more.
Thanks, Alice! Too bad I won't be able to apply VunderBob's and MsRobyn's advice to demand the existing copy of my records (which are indeed on paper), but what you say makes sense to me.

And thanks for the urgent care suggestion as well; there's one quite near me and they are affiliated with the same hospital/health-care group that my old doctor was with, too, so that should help...
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  #24  
Old 04-03-2012, 03:34 AM
ambushed ambushed is offline
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Originally Posted by psychobunny View Post
FWIW the pracice is obligated to take care of you for that 30 days until you find a new doctor which includes filling your maintenance medications.
That makes a great deal of sense to me, so thank you for at least an informal answer to one of my two question in my OP! But may I ask what leads you to that conclusion? I'd dearly like to cite such a rule in my communications with that practice as well as with the state medical board, if you can dig such a thing up.
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  #25  
Old 04-03-2012, 03:50 AM
ambushed ambushed is offline
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Originally Posted by Ca3799 View Post
I have only seen a termination of relationship notice like that a few times in my nursing career and it was always instituted by the doctor who no longer wanted to see the patient, usually for serious non-compliance to the point the Doc would be worried about legal problems, or for having the feeling that the patient was argumentative, hostile or threatening and would no longer be welcome in the office.

Also, whenever a notice was sent terminating the relationship, it was usually sent certified mail, return receipt, so that there was proof the letter was received.
Which is just what happened here (though without a signature which my research thus far tells me makes the letter meaningless), which is one of the reasons I'm so confident this was deliberately and intentionally done by the doctor in question. Otherwise, that routine legal advice would not have been followed at all.

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Originally Posted by Ca3799 View Post
I have never seen a case where the relationship with a whole group was terminated because one Doc died and the other docs could not or did not want to absorb that Doc's patient load, and I suppose that is possible, but it seems unlikely to me...
Agreed, and as I elaborated elsewhere, even though I specifically mentioned in my fax that I'd completely understand if the doctor in question didn't have room for me, the practice didn't use that reason, which would have let them completely off the hook.

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Originally Posted by Ca3799 View Post
... Have there been any 'incidents' you would care to relate?
Nothing at all. I've occasionally "stumped" my doctors in the past with so-called "paradoxical" reactions and similar puzzlers, but nothing problematic or troubling. And I've never pursued legal actions against any doctor (or anyone else, for that matter), though I am going to make a fuss over this unlawful patient abandonment!
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  #26  
Old 04-03-2012, 04:06 AM
ambushed ambushed is offline
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Before I call it a night, it appears I need to emphasize a few things.

First, contrary to what some replies seem to suggest, I did not post here to whine or complain or to inquire about the reasons behind this! Please note this! My purpose was to pose two General Questions, neither of which has yet been answered with any citation or legal authority that I can use and pass on. I shall once again repeat them:

(1): Is an unsigned patient termination letter legally binding, or is it as if I'd never received it, thus making the refusal of continuing care quite illegal? If so, please provide a cite confirming this fact.

(2): Does the legal obligation for continuing care officially include the continuing legal obligation to refill daily prescriptions, or not? If so, please provide a cite confirming this fact.


Thank you!


(For what it's worth, I still think this belongs in General Questions!)
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  #27  
Old 04-03-2012, 05:39 AM
BigT BigT is offline
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Originally Posted by MsRobyn View Post
If, on the other hand, the practice manager turns out to be a dildo, then take it to the doctors by sending a return-receipt letter addressed to each of them that lays out the entire situation, what you've already done to resolve it, and that you intend to terminate your relationship with their practice effective immediately because of your dissatisfaction with the way their practice is managed.
Why in the world would this accomplish anything? Terminating your relationship with the practice is what they already want. Shouldn't you be giving them not what they want? Like, I don't know, pointing out that patient abandonment is illegal and that if the situation is not resolved promptly the next conversation may be with a lawyer?

I know ambushed isn't planning on suing, but they don't know that. Not signing a letter is not going to get them out of refusing to set up an appointment and refusing medical treatment. (It wouldn't surprise me if the letter was left unsigned so they can deny its existence later

I would also recommend the OP pursue appointments with every doctor in the area. Not because he's admitting to having seen the letter, but because he still can't get the refills to the medicines he needs. I know of at least a couple doctors that will help out in situations like this in my area of the woods, so they may exist in the OP's area as well.

Whether illegal in her state or not, I still can't get past how unethical this behavior is. Any ethical doctor would prescribe the medicines until the termination date. Even if the patient wouldn't die, it does cause suffering and possible harm. I lament that there will likely be no punishment for this, as I don't think that any doctor this unethical deserves to practice. And I'd feel the same if the OP were an actual drug seeker

Sorry I can't help you with your actual GQ questions, other than to suggest consulting a lawyer in your jurisdiction. (Since no lawyer has weighed in yet, I suspect they think it's too sticky a situation to get involved in.)
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  #28  
Old 04-03-2012, 06:06 AM
MsRobyn MsRobyn is offline
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I'm bowing out of this thread. I have nothing further to say, and apparently got so much wrong that I can't defend anything I posted.
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  #29  
Old 04-03-2012, 06:24 AM
Ferret Herder Ferret Herder is offline
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Originally Posted by ambushed View Post
Is that illegal, especially in light of the unsigned letter? Does it violate an AMA or other ethics code?
FYI, the AMA (American Medical Association) is a voluntary-to-join, lobbying and professional association. IIRC, they have no legal or regulatory jurisdiction over their membership. They do have ethics codes and the like but these do not have power in terms of medical licensing; it only affects whether they kick the doctor out of their organization.

I agree with BigT's statement that considering the situation, this may not be something that can be resolved over the Internet, and you may need to speak to someone in person about any legal issues.
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  #30  
Old 04-03-2012, 07:39 AM
boytyperanma boytyperanma is offline
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Originally Posted by ambushed View Post
Before I call it a night, it appears I need to emphasize a few things.

First, contrary to what some replies seem to suggest, I did not post here to whine or complain or to inquire about the reasons behind this! Please note this! My purpose was to pose two General Questions, neither of which has yet been answered with any citation or legal authority that I can use and pass on. I shall once again repeat them:

(1): Is an unsigned patient termination letter legally binding, or is it as if I'd never received it, thus making the refusal of continuing care quite illegal? If so, please provide a cite confirming this fact.

(2): Does the legal obligation for continuing care officially include the continuing legal obligation to refill daily prescriptions, or not? If so, please provide a cite confirming this fact.


Thank you!


(For what it's worth, I still think this belongs in General Questions!)
Well your problem might be you can't follow even the simplest instructions so that office has no interest in dealing with you.

This isn't the place to get legal advice and your questions were moved here because it is against the boards rules to ask for answers that are legal advice, you only get opinions.

You can swear up and down that you never received that letter 'because it wasn't signed' but it really doesn't matter at this point because you acknowledge receipt and understanding of the letter. Claiming you never got the letter or that they didn't inform you they were canceling your care isn't getting you anywhere. They can prove you were informed.
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  #31  
Old 04-03-2012, 08:03 AM
Little Nemo Little Nemo is offline
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Haven't read all the posts so my apologies if this point's already been raised. But one possibility is that the practice doesn't have room for the OP. They lost one doctor which means the remaining doctors are presumably all handling more patients. And I've been told there are legal limits on how many patients a doctor can carry.

As for the OP's specific question, I'm not a lawyer or a physician but I don't think there's any legal requirement that a doctor has to continue treating a patient except in emergency situations. If the doctor decides he doesn't want a patient, I'd assume all he has to do is give sufficient notice to the patient that they should find another doctor.
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  #32  
Old 04-03-2012, 08:37 AM
ShelliBean ShelliBean is offline
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Is your goal to be treated by this doctor's group? Or is this simply a mental exercise in what is wrong vs. what is right or legal?

Because I can tell you what I think, but I can't tell you what the legality of any of it is simply because I don't know.
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  #33  
Old 04-03-2012, 11:07 AM
Foxy40 Foxy40 is offline
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Since I send out these types of letters on a regular basis I will try to help you.

1. As far as the legality of the letter. The point of the letter is to advise you to find another physician as they are no longer willing to treat you. If you happen to drop dead on the 31st day because you refused to accept the letter and didn't attempt to find care elsewhere, perhaps you would have a case of abandonment. Otherwise, that shouldn't even be an issue to you. You can not go back and demand to be seen.

2. They are obligated to refill your medication for those 30 days. You were a little vague regarding whether or not they did so. Usually I will send a prescription with the letter for the next 30 days if there weren't refills left. (Unless they are narcotic pain relievers).

3. I feel like you want reasons and it is likely you won't get them so simply find another doctor. I discharge patients because we are a specialty practice and we don't do long term care but refer people back to their primary. I discharge them when they are on long term pain medications because we aren't a pain clinic. I discharge them when they fail drug tests. I discharge them when they are rude to my staff. I discharge them for non payment of fees. I discharge them when they fail to keep appointments. Sometimes we discharge them simply because they have personalities that conflict with their provider for whatever reason.

If it is a private office, they have no obligation to keep you whether or not your regular doctor was still alive. They are obligated to give you enough time to find someone else and treat you for a reasonable time until you do.

Saying to yourself that the letter isn't valid might make you feel better but in the end, it makes no difference. You have been discharged, request a records transfer and move on. And no, you aren't entitled to the original records. They belong to the practice but you ARE entitled to a copy of all your medical information at a reasonable copy and mailing price.
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  #34  
Old 04-03-2012, 11:12 AM
IvoryTowerDenizen IvoryTowerDenizen is offline
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Originally Posted by boytyperanma View Post

You can swear up and down that you never received that letter 'because it wasn't signed' but it really doesn't matter at this point because you acknowledge receipt and understanding of the letter. Claiming you never got the letter or that they didn't inform you they were canceling your care isn't getting you anywhere. They can prove you were informed.
He's not saying he's going to claim he never received it.

He's asking if the net effect of the letter, unsigned, is AS IF, he was never sent such a letter. It has no effect unsigned, so it's AS IF the practice just dropped him.

I don't know the answer, but I can imagine the question: Is an unsigned letter enforceable? having a concrete answer. I don't know what the answer is, though.
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  #35  
Old 04-03-2012, 11:16 AM
Foxy40 Foxy40 is offline
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As I look up, it appears they are ignoring your pharmacists phone calls. If the medication is life and death, it is the office's best interest to refill it due to liability concerns if something should happen to you. When I said obligated I meant in reference to acceptable standards of care. In my state, there is no LEGAL obligation. It is the CYA protocol that most follow. If you are on medications like allergy pills or migraine medication or other "improve the quality of life" medications, they probably don't have to refill them but there may be different laws in your state.
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  #36  
Old 04-03-2012, 11:20 AM
Foxy40 Foxy40 is offline
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Originally Posted by IvoryTowerDenizen View Post
He's not saying he's going to claim he never received it.

He's asking if the net effect of the letter, unsigned, is AS IF, he was never sent such a letter. It has no effect unsigned, so it's AS IF the practice just dropped him.

I don't know the answer, but I can imagine the question: Is an unsigned letter enforceable? having a concrete answer. I don't know what the answer is, though.
This would only be an issue if he is injured in some way before finding a new doctor. If the letter was sent certified mail as is the custom, there is record of receipt so I doubt the office would have much of a liability, signed or not, if he refuses to seek medical care elsewhere as soon as possible.
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  #37  
Old 04-03-2012, 11:21 AM
LurkerInNJ LurkerInNJ is offline
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Shouldn't you be spending your time and energy finding another doctor asap rather than wasting time splitting hairs about your old doctor's office?
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  #38  
Old 04-03-2012, 11:30 AM
ZooHoot ZooHoot is offline
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I was terminated by a practice. I got a certified letter. I assume signing for it, meant the practice then had it on record they got my letter. My letter told me they would see me only for an emergency in the next 30 days, and that was it.

A doctor can refuse refills for almost any reason, so I doubt the practice is doing anything illegal. I would think that insurance probably is the reason.
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  #39  
Old 04-03-2012, 11:44 AM
IvoryTowerDenizen IvoryTowerDenizen is offline
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Originally Posted by Foxy40 View Post
This would only be an issue if he is injured in some way before finding a new doctor. If the letter was sent certified mail as is the custom, there is record of receipt so I doubt the office would have much of a liability, signed or not, if he refuses to seek medical care elsewhere as soon as possible.
I agree. I was simply clarifying that I didn't think he was going to claim he never received it, just asking if it being unsigned was the equivalent of it never existing.

I don't think he was planning to lie, in other words.
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Old 04-03-2012, 01:07 PM
Ferret Herder Ferret Herder is offline
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Originally Posted by IvoryTowerDenizen View Post
He's asking if the net effect of the letter, unsigned, is AS IF, he was never sent such a letter. It has no effect unsigned, so it's AS IF the practice just dropped him.

I don't know the answer, but I can imagine the question: Is an unsigned letter enforceable? having a concrete answer. I don't know what the answer is, though.
Considering his only references for that argument came from a site with questionable veracity, I would suggest that there may well be little support for that possibility. However, IANAL, so I don't know.
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  #41  
Old 04-03-2012, 02:00 PM
Taomist Taomist is offline
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What I'm getting from this so far is that

-It's not illegal for a doctor to drop a patient without reason, with a 30 day notice. So, signed or not, the letter doesn't even matter.
-The office is required to continue care until the 30 days are up, including meds.

If it were me, I'd concentrate on getting those meds, make the office DO ITS JOB until time runs out, and give up on the office. Get copies of your files and walk away.
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  #42  
Old 04-04-2012, 01:37 AM
ambushed ambushed is offline
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Originally Posted by BigT View Post
Why in the world would this accomplish anything? Terminating your relationship with the practice is what they already want. Shouldn't you be giving them not what they want? Like, I don't know, pointing out that patient abandonment is illegal and that if the situation is not resolved promptly the next conversation may be with a lawyer?

I know ambushed isn't planning on suing, but they don't know that. Not signing a letter is not going to get them out of refusing to set up an appointment and refusing medical treatment. (It wouldn't surprise me if the letter was left unsigned so they can deny its existence later

I would also recommend the OP pursue appointments with every doctor in the area. Not because he's admitting to having seen the letter, but because he still can't get the refills to the medicines he needs. I know of at least a couple doctors that will help out in situations like this in my area of the woods, so they may exist in the OP's area as well.

Whether illegal in her state or not, I still can't get past how unethical this behavior is. Any ethical doctor would prescribe the medicines until the termination date. Even if the patient wouldn't die, it does cause suffering and possible harm. I lament that there will likely be no punishment for this, as I don't think that any doctor this unethical deserves to practice. And I'd feel the same if the OP were an actual drug seeker

Sorry I can't help you with your actual GQ questions, other than to suggest consulting a lawyer in your jurisdiction. (Since no lawyer has weighed in yet, I suspect they think it's too sticky a situation to get involved in.)
Wow, finally! Huge thanks, BigT! Even though you couldn't answer my two main questions, I'm greatly indebted to you for your otherwise perfectly on point and very valuable reply. I'm delighted you recognized the key points here!

Yesterday (Tuesday), I made an appointment with what I dearly hope to be my new, very well-educated, compassion-award-winning doctor (it's a meet and greet so that I can be assured she doesn't have any reluctance to care for me in advance), but she's out of town for the next ten days or so.

As far as getting refills, I haven't solved that yet but I'm considering asking my kidney specialist (my family too easily forms stones), with whom I have an excellent relationship, if he would be willing to do so until I have a new primary-care doctor. If not, then I'll try the urgent care/hospital as suggested earlier.

But again, thank you for recognizing the truly egregious ethical and legal violations in this situation! I think my next step will be to visit one of those online "ask a lawyer" sites. You pose your question, then one or another attorney emails you, giving a price (much lower than what a sit-down appointment would cost) for answering your question, after which you can optionally pursue the situation further.

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  #43  
Old 04-04-2012, 01:43 AM
ambushed ambushed is offline
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Originally Posted by MsRobyn View Post
I'm bowing out of this thread. I have nothing further to say, and apparently got so much wrong that I can't defend anything I posted.
I very much hope I haven't angered or offended you! Truly, I am very grateful for your replies. Please be assured of that -- you're clearly one sharp person!
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  #44  
Old 04-04-2012, 01:45 AM
ambushed ambushed is offline
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Originally Posted by Ferret Herder View Post
FYI, the AMA (American Medical Association) is a voluntary-to-join, lobbying and professional association. IIRC, they have no legal or regulatory jurisdiction over their membership. They do have ethics codes and the like but these do not have power in terms of medical licensing; it only affects whether they kick the doctor out of their organization.

I agree with BigT's statement that considering the situation, this may not be something that can be resolved over the Internet, and you may need to speak to someone in person about any legal issues.
Thanks!
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  #45  
Old 04-04-2012, 01:47 AM
ambushed ambushed is offline
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Originally Posted by boytyperanma View Post
Well your problem might be you can't follow even the simplest instructions so that office has no interest in dealing with you.

This isn't the place to get legal advice and your questions were moved here because it is against the boards rules to ask for answers that are legal advice, you only get opinions.

You can swear up and down that you never received that letter 'because it wasn't signed' but it really doesn't matter at this point because you acknowledge receipt and understanding of the letter. Claiming you never got the letter or that they didn't inform you they were canceling your care isn't getting you anywhere. They can prove you were informed.
Insulting and useless.
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  #46  
Old 04-04-2012, 01:54 AM
ambushed ambushed is offline
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Haven't read all the posts so my apologies if this point's already been raised. But one possibility is that the practice doesn't have room for the OP. They lost one doctor which means the remaining doctors are presumably all handling more patients. And I've been told there are legal limits on how many patients a doctor can carry.
I've addressed that issue several times now. I specifically told the doctor in my fax that I would completely understand if he did not have room for me, yet he never offered that as an explanation, only that I "needed to see a specialist", which is bullshit.

Quote:
Originally Posted by Little Nemo View Post
As for the OP's specific question, I'm not a lawyer or a physician but I don't think there's any legal requirement that a doctor has to continue treating a patient except in emergency situations. If the doctor decides he doesn't want a patient, I'd assume all he has to do is give sufficient notice to the patient that they should find another doctor.
That's definitely not true. If you're interested, see the links I provided here, where you'll see that it is indeed illegal to abandon a patient in the way he did in my case, and malpractice lawyers issue dire warnings against what he did.
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  #47  
Old 04-04-2012, 02:09 AM
ambushed ambushed is offline
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Originally Posted by ShelliBean View Post
Is your goal to be treated by this doctor's group? Or is this simply a mental exercise in what is wrong vs. what is right or legal?
Neither. As I explained elsewhere, I wish to pursue legal action -- just short of a lawsuit -- against the doctor and the practice for their quite illegal "patient abandonment", particularly in refusing to refill my vitally necessary regular medications. I posted my OP to General Questions in order to try to get answers to two straightforward General Questions (highlighted in blue, above) that, if I actually knew the answers, would help me determine whether the law was unequivocally violated or not.

I didn't expect everyone to know the answers (though boytyperanma's juvenile, wrong-headed, and contemptible reply is bullshit in every respect, because I am NOT asking for "legal advice", only the answers to two General Questions that apply not just to me but to anyone throughout the U.S.), but I was hoping someone might know. But it's perfectly fine that you don't happen to know, so no worries.
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  #48  
Old 04-04-2012, 02:17 AM
ambushed ambushed is offline
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Originally Posted by Foxy40 View Post
Since I send out these types of letters on a regular basis I will try to help you.

1. As far as the legality of the letter. The point of the letter is to advise you to find another physician as they are no longer willing to treat you. If you happen to drop dead on the 31st day because you refused to accept the letter and didn't attempt to find care elsewhere, perhaps you would have a case of abandonment. Otherwise, that shouldn't even be an issue to you. You can not go back and demand to be seen.

2. They are obligated to refill your medication for those 30 days. You were a little vague regarding whether or not they did so. Usually I will send a prescription with the letter for the next 30 days if there weren't refills left. (Unless they are narcotic pain relievers).

3. I feel like you want reasons and it is likely you won't get them so simply find another doctor. I discharge patients because we are a specialty practice and we don't do long term care but refer people back to their primary. I discharge them when they are on long term pain medications because we aren't a pain clinic. I discharge them when they fail drug tests. I discharge them when they are rude to my staff. I discharge them for non payment of fees. I discharge them when they fail to keep appointments. Sometimes we discharge them simply because they have personalities that conflict with their provider for whatever reason.

If it is a private office, they have no obligation to keep you whether or not your regular doctor was still alive. They are obligated to give you enough time to find someone else and treat you for a reasonable time until you do.

Saying to yourself that the letter isn't valid might make you feel better but in the end, it makes no difference. You have been discharged, request a records transfer and move on. And no, you aren't entitled to the original records. They belong to the practice but you ARE entitled to a copy of all your medical information at a reasonable copy and mailing price.
Thank you, but what you say contradicts what is reported in the links I've provided. Perhaps you aren't adequately familiar with the laws in this regard. It is indeed quite illegal to abandon a patient in the way I was. Whether I could win a lawsuit based on the limited damages I have suffered as a result is certainly very doubtful, but a lawsuit is far from the only legal remedy I have.

As for the letter being unsigned, every bit of information I can find definitively asserts that an unsigned letter is no letter at all. This matters very much indeed because, until I receive a signed, legally binding letter of termination, the 30-day period doesn't even begin, let alone expire! Thus, the patient abandonment gets more and more harmful over time.
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Old 04-04-2012, 02:19 AM
ambushed ambushed is offline
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Originally Posted by IvoryTowerDenizen View Post
He's not saying he's going to claim he never received it.

He's asking if the net effect of the letter, unsigned, is AS IF, he was never sent such a letter. It has no effect unsigned, so it's AS IF the practice just dropped him.

I don't know the answer, but I can imagine the question: Is an unsigned letter enforceable? having a concrete answer. I don't know what the answer is, though.
Exactly! Thank you, thank you, thank you wise and perceptive sir or madam!

Last edited by ambushed; 04-04-2012 at 02:19 AM..
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  #50  
Old 04-04-2012, 02:21 AM
ambushed ambushed is offline
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Originally Posted by LurkerInNJ View Post
Shouldn't you be spending your time and energy finding another doctor asap rather than wasting time splitting hairs about your old doctor's office?
Shouldn't you be reading the thread far more carefully rather than making up crap to insult me with?
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