# Can a doctor "fire" a patient? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [April 22, 2015, 4:58pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297 "2015-04-22T16:58:03Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [April 23, 2015, 1:16am UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/21 "2015-04-23T01:16:33Z")
My neurologist stopped taking patients who were self-pay. You had to have insurance. ☹ ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [April 23, 2015, 1:31am UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/22 "2015-04-23T01:31:46Z")
I was fired by a dentist for missing an appointment. Well, I thought I was fired. I told them I could only make the first appointment of the morning, they said they wouldn’t give it to me since missed one, and so I found a new dentist. But when I asked the old dentist to send my records to the new one, they were shocked and hurt that I was leaving, and promised to be really nice to me if I came back. It was kind of surreal. I went to the new dentist. I still wonder if the old dentist wasn’t a better dentist, though. A friends was fired by her pcp. They weren’t a good fit in a bunch of ways, and the new doctor recommended by the one who fired my friend worked out much better. ---
**Author:** ![handsomeharry](https://avatars.discourse-cdn.com/v4/letter/h/e9c0ed/32.png) [@handsomeharry](https://boards.straightdope.com/u/handsomeharry)\ **Post date:** [April 23, 2015, 1:35am UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/23 "2015-04-23T01:35:31Z")
> [@FairyChatMom](#): > > Is there anything in a doctor’s oath or ethics that would prevent him/her from telling a patient to go elsewhere? I’m thinking specifically of an individual I know who has to be making his doctors crazy. He has Type II diabetes and he refuses to change his diet or activity level, he won’t take his meds, and he just ended up in the hospital for emergency heart surgery. I’m pretty sure he’s got BP and cholesterol issues also. > > I don’t know all of the details, but I couldn’t help thinking that if this guy was my patient, I’d not want to deal with him any longer. Which got me to wondering, is there any reason a doctor couldn’t just tell a patient: “You don’t follow my instructions so there’s nothing I can do for you. I won’t see you any longer.” Anyone you know every been let go by a doctor? Yep. My mum, about 5 years ago. Dr.'s nurse called and said “Since she won’t do what he wants, adios”. There we have it. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 23, 2015, 2:35am UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/24 "2015-04-23T02:35:45Z")
> [@LSLGuy](#): > > You didn’t ask, but the situation is similar for lawyers. Although there are restrictions on firing clients during the course of a trial. I have a relative who, while going through a very nasty divorce, was going to play the false sexual abuse charge card, and her lawyer told her that this was one of the things that would happen to her if she did it. The kids, who are now adults, have nothing to do with their father or his side of the family, and our mutual relatives will not tell me why. After hearing about this, and some of the other things SHE did, I probably don’t want to know anyway. This was a situation where I honestly think the kids would have been better off in foster care for some of that time. ☹ BTW, the main reason she didn’t file the charges was not because of her lawyer threatening to cut her off, or the likelihood that her ex would get SOLE custody (not joint, which they had at the time) but because the kids denied that anything like that had ever happened and weren’t going to go along with it. :eek: ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 23, 2015, 2:37am UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/25 "2015-04-23T02:37:26Z")
> [@Guinastasia](#): > > My neurologist stopped taking patients who were self-pay. You had to have insurance. ☹ That’s interesting. I’d think that a doctor wouldn’t mind self-pay patients, as long as they DID pay, because there are no billing hassles. 😕 ---
**Author:** ![yellowjacketcoder](https://avatars.discourse-cdn.com/v4/letter/y/4bbf92/32.png) [@yellowjacketcoder](https://boards.straightdope.com/u/yellowjacketcoder)\ **Post date:** [April 23, 2015, 2:48am UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/26 "2015-04-23T02:48:22Z")
> [@nearwildheaven](#): > > That’s interesting. I’d think that a doctor wouldn’t mind self-pay patients, as long as they DID pay, because there are no billing hassles. 😕 I imagine you’ve nailed the issue on the head - self-pay patients are notorious for not actually paying their bills. EDIT: with insurance, you have SOME guarantee that your bill will at least be partially paid, as long as the procedure wasn’t denied. ---
**Author:** ![iljitsch](https://avatars.discourse-cdn.com/v4/letter/i/77aa72/32.png) [@iljitsch](https://boards.straightdope.com/u/iljitsch)\ **Post date:** [April 23, 2015, 12:45pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/27 "2015-04-23T12:45:56Z")
> [@nearwildheaven](#): > > because the kids denied that anything like that had ever happened and weren’t going to go along with it. :eek: Doesn’t it suck when you accidentally raised your kids well enough to not go along with your evil plans? 😕 ---
**Author:** ![Shinna\_Minna\_Ma](https://avatars.discourse-cdn.com/v4/letter/s/f08c70/32.png) [@Shinna\_Minna\_Ma](https://boards.straightdope.com/u/Shinna_Minna_Ma)\ **Post date:** [April 23, 2015, 2:48pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/28 "2015-04-23T14:48:30Z")
My wife is a medical secretary for a child psychiatrist. He (the doctor) has fired patients, although he’s really firing the patients’ parents. It hasn’t happened often, but it does occur. Most of the time it’s because the parent(s) refuse to manage the meds and ensure the kid takes them as prescribed. There were also a very few cases where the parents were so obnoxious to the secretary (my wife) that the doctor gave them a list of other psychiatrists he recommended. Incidentally, all the patients are self-pay, as the doctor takes no insurance. ---
**Author:** ![OneCentStamp](https://avatars.discourse-cdn.com/v4/letter/o/13edae/32.png) [@OneCentStamp](https://boards.straightdope.com/u/OneCentStamp)\ **Post date:** [April 23, 2015, 2:59pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/29 "2015-04-23T14:59:45Z")
We have had to do it from time to time as a last resort, usually as a result of patients being abusive with doctors or staff, chronically noncompliant, or unreasonably threatening us with legal action. We always do it in writing, and we always: 1. Frankly state the reason(s) for the discharge. 2. Give a time frame, usually 60 days, after which the patient will no longer be under our care. 3. Offer to refer to another provider in the area, often giving a suggestion or list of suggestions, and offer to forward the patient’s records to that provider. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [April 23, 2015, 3:02pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/30 "2015-04-23T15:02:18Z")
I know a woman who is a dentist. She _hates_ no-shows, so if someone misses an appointment she will not see them again unless they start over. That entails recreating the record, which has a $100 fee that she normally waives. So, start as a new patient and the $100 record fee is waived. But, miss an appointment and the fee is not waived if you want reinstated. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [April 23, 2015, 3:09pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/31 "2015-04-23T15:09:32Z")
> [@OneCentStamp](#): > > We have had to do it from time to time as a last resort, usually as a result of patients being abusive with doctors or staff, chronically noncompliant, or unreasonably threatening us with legal action. What is the reason behind not wanting to see a non-compliant patient? If my mechanic tells me to check my oil weekly, but I do not, he’ll happily repair the damage I cause as long as I’m paying. ---
**Author:** ![Bridget\_Burke](https://avatars.discourse-cdn.com/v4/letter/b/7cd45c/32.png) [@Bridget\_Burke](https://boards.straightdope.com/u/Bridget_Burke)\ **Post date:** [April 23, 2015, 3:31pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/32 "2015-04-23T15:31:59Z")
> [@kayaker](#): > > What is the reason behind not wanting to see a non-compliant patient? If my mechanic tells me to check my oil weekly, but I do not, he’ll happily repair the damage I cause as long as I’m paying. Possibly because it’s more depressing to see someone killing themselves because they ignore your advice than watching someone damage their car. The noncompliant patient will also run out of money & treatment options & faster. And possibly consider suing because you aren’t “curing” them… ---
**Author:** ![OneCentStamp](https://avatars.discourse-cdn.com/v4/letter/o/13edae/32.png) [@OneCentStamp](https://boards.straightdope.com/u/OneCentStamp)\ **Post date:** [April 23, 2015, 3:36pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/33 "2015-04-23T15:36:48Z")
> [@kayaker](#): > > What is the reason behind not wanting to see a non-compliant patient? If my mechanic tells me to check my oil weekly, but I do not, he’ll happily repair the damage I cause as long as I’m paying. An example would be a patient who rejected multiple cornea transplants because of chronic failure to adhere to the postoperative regimen of steroid and antibiotic eye drops. Eventually, our doctor said, in effect, “If you won’t be responsible for your own post-op care, I’m not comfortable being party to the results of your actions. Furthermore, I’m not comfortable ordering another $2000 donor cornea for you, when that tissue might go to another patient who won’t waste it with noncompliance.” ---
**Author:** ![RivkahChaya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rivkahchaya/32/8919_2.png) [@RivkahChaya](https://boards.straightdope.com/u/RivkahChaya)\ **Post date:** [April 23, 2015, 4:55pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/34 "2015-04-23T16:55:16Z")
> [@Bridget\_Burke](#): > > Possibly because it’s more depressing to see someone killing themselves because they ignore your advice than watching someone damage their car. > > The noncompliant patient will also run out of money & treatment options & faster. And possibly consider suing because you aren’t “curing” them… Also, because according to my cousin who is a doctor, many non-compliant patients are sure that the doctor is withholding an easier fix, and bad-mouth the doctor to other people: “She could just give me a pill to fix X, but instead she wants me to change my diet and exercise every day. I don’t have time for that.” My cousins says one of her pet peeves is how she can lecture herself blue about eating better and getting exercise to a patient, who pays no attention whatsoever, and claims the doctor is unhelpful, then gets the _exact same advice_ from some woo practitioner, or the counter guy at the GNC, and suddenly is moved to follow it to a T, begins to feel much better, and goes on to anyone who will listen about how the woo practitioner fixed “Everything,” when the doctor was worthless. ---
**Author:** ![purplehearingaid](https://avatars.discourse-cdn.com/v4/letter/p/7bcc69/32.png) [@purplehearingaid](https://boards.straightdope.com/u/purplehearingaid)\ **Post date:** [April 23, 2015, 5:42pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/35 "2015-04-23T17:42:23Z")
Yes a doctor can say a patient was 'non compliance ’ , a doctor refused to see me anymore b/c I did no want to a lot of x rays and take meds . I had trouble understanding the doctor she had a thick Russian accent , and was looking for another doctor. So the doctor gave me a favor by not seeing me anymore. 🙂 ---
**Author:** ![Missy2U](https://avatars.discourse-cdn.com/v4/letter/m/3bc359/32.png) [@Missy2U](https://boards.straightdope.com/u/Missy2U)\ **Post date:** [April 23, 2015, 5:46pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/36 "2015-04-23T17:46:15Z")
Years ago, (maybe 30?) my mom’s therapist (I don’t know if he was a psychotherapist or a psychologist) fired her - he refused to see her if she didn’t stop the pills and the booze and get some treatment for those issues first. She said (and still says to this day) that that was the worst, and best, day of her life. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 23, 2015, 6:13pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/37 "2015-04-23T18:13:53Z")
> [@Shinna\_Minna\_Ma](#): > > My wife is a medical secretary for a child psychiatrist. He (the doctor) has fired patients, although he’s really firing the patients’ parents. It hasn’t happened often, but it does occur. Most of the time it’s because the parent(s) refuse to manage the meds and ensure the kid takes them as prescribed. There were also a very few cases where the parents were so obnoxious to the secretary (my wife) that the doctor gave them a list of other psychiatrists he recommended. > > Incidentally, all the patients are self-pay, as the doctor takes no insurance. My aforementioned relative had the same thing happen to her, for saying things like “Now, tell the nice counselor how much you hate Daddy.” :smack: BTW, the kids are both boys. I wonder how she would feel if their sons ever get divorced and their exes pull stunts like that. ---
**Author:** ![Q.N.Jones](https://avatars.discourse-cdn.com/v4/letter/q/3da27b/32.png) [@Q.N.Jones](https://boards.straightdope.com/u/Q.N.Jones)\ **Post date:** [April 23, 2015, 6:36pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/38 "2015-04-23T18:36:48Z")
I’m working with a psychiatry clinic right now to decide what their policy should be regarding “firing patients.” So I’ve been researching the policies that ambulatory care clinics have about this, in primary care and other specialties too. It generally boils down to this: –Doctors like to threaten to fire patients when they are blowing off steam in private with their colleagues and co-workers. This is often how the docs indicate to non-clinical administrators that they are feeling the demands made of them are too much to handle. –Most doctors rarely, if ever, actually fire a patient because they recognize that virtually all patients are non-compliant some of the time–they would be out of business. –Some doctors will “fire” patients for chronic no-show behavior that is documented. –Virtually all doctors will fire a patient who is violent with staff, or who threatens violence against staff. –Patients rarely get fired for any other reasons because the doctors are worried about the liability ramifications. –Ceasing to take a certain type of insurance (or self-pay patients) is not seen as “firing a patient,” and is done much more casually. It’s either a business decision, or the payer stops allowing the provider in their network. NOTE: Firing patients is much more common in child psychiatry because success depends on the cooperation of the parents. Child psychiatrists are also painfully aware that there are far too few providers within their specialty. So they feel more comfortable firing patients because they don’t believe any progress can be made where certain basic parental cooperation doesn’t exist. They then try to fill that spot with a patient more likely to experience improvement. ---
**Author:** ![OneCentStamp](https://avatars.discourse-cdn.com/v4/letter/o/13edae/32.png) [@OneCentStamp](https://boards.straightdope.com/u/OneCentStamp)\ **Post date:** [April 23, 2015, 7:19pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/39 "2015-04-23T19:19:50Z")
> [@Q.N.Jones](#): > > –Most doctors rarely, if ever, actually fire a patient because they recognize that virtually all patients are non-compliant some of the time–they would be out of business. This is an important point. I’ve been at my current practice for five years, we’ve onboarded probably 40,000 patients in that time span, and we’ve probably discharged five or six patients from our care. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [April 23, 2015, 11:52pm UTC](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297/40 "2015-04-23T23:52:18Z")
> [@kayaker](#): > > I know a woman who is a dentist. She _hates_ no-shows, so if someone misses an appointment she will not see them again unless they start over. That entails recreating the record, which has a $100 fee that she normally waives. > > So, start as a new patient and the $100 record fee is waived. But, miss an appointment and the fee is not waived if you want reinstated. What I expected the dentist to do was charge me for the appointment I’d missed. And I was happy to pay for it, since it was entirely my fault. Instead, the receptionist just refused to give me another appointment I could get to. [Previous page](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297.md?page=1) [Next page](https://boards.straightdope.com/t/can-a-doctor-fire-a-patient/718297.md?page=3)