Br. Bob is a primary care physician in the Southeastern U.S., writing for Medpage Today, a physician research-summary and commentary service. Medpage Today features several doctor bloggers, which enables it to offer a range of ages and specialties.

Dr. Bob’s full post discussed why patients leave doctors and why doctors “discharge” patients from their practices.

He also mentions another point.

Non-compliance.

Some doctors think it raises their liability for lawsuits if patients don’t follow their orders. Dr. Bob takes a more compassionate view of the patient who doesn’t do what the care plan calls for. You can read about that in the full post.

Medpage Today

…”Doctors Ditching Patients

“The other side is quite different.  The patient often comes into the relationship broken and needy.  They are looking for help, guidance, and care.  Less is expected of them because they don’t give, they receive.  So the ending of the relationship can feel like abandonment.  You are telling them that you won’t meet their needs anymore.

“Those of us who are quick to feel guilt find it very hard to end the relationship.  It takes a lot for me to discharge a patient — more than most doctors.  For me, there are three main reasons:

1. “They don’t pay their bill when they can afford to — this tells me that they don’t value me or my services.  It’s a big insult to doctors to feel less valued than cable TV or cigarettes.
2. “They lie to get controlled substances — this not only undermines our trust in the patient, but it puts our career at risk.  I can lose my license by carelessly prescribing controlled drugs like Xanax and Percocet.  I didn’t go to medical school and residency to become a vending machine.
3. “They mistreat my office staff — this one is a little harder to judge.  Some people just don’t relate to others well (ie. they are jerks).  This shouldn’t be a complete barrier to care, but if it goes far enough, I will discharge them.  Losing a good staff person is far worse than losing a patient, and an unsupportive boss can kill morale.  I spend every day with these people and rely on their hard work; I can’t afford to discourage them.”

Source: Medpage Today, Dr. Bob Blog, October 23, 2009