Patient abandonment

[thanksforadvice]

Hi,
This is regarding a possible patient abandonment in California.

A doctor treating patients (in a special field) visited a forum after being tipped off, where patients from all over the world discuss their specific treatments for this particular disease he treats.

The doctor saw a post about him. His name was not mentioned, forum rules say we are not allowed to use doctor names, but we are allowed to use initials, i.e., Dr. D.

The main question in the post was asking a new patient asking how to get a hold of this Md - as his office never answers the phones, you can only leave messages, often mailboxes are full and you cannot leave a message. It was urgent as a patient needed to cancel an appointment or get fined by the MD $100 if not done within one week of the appt. So she posted where she knew other of his patients would be and hopefully could help.

Many responses were negative such as "don't bother, I am feeling worse since seeing this Md", "their office is chaotic and they never answer phones or return calls" ...etc. 30 posts in all 75% warned it was like this all the time and there is no way to get through. Really idle patient to patient chatter.

The Md (we believe) was notified by a patient at the forum that HE was being discusssed in the forum. He apparently then visited the forum and was able (I don't know exactly how) to figure out the patients names...some members use their first name as their "user id".

He called several of the patients that had responded to the post and told them he didn't appreciate that they were discussing him, he was angry at the patients for saying "the office was chaotic" etc., and told them they were no longer welcome at his practice and dropped them on the spot. One girl asked that he please allow her to see him one last time to go over lab results, he said, "No find another doctor". This is a disease that is very rare and find a good specialist in the field is very difficult. When you are lucky enough to find a doctor who treats this disease there are often months to wait for new patients to get in. This doctor is well aware of that fact.

Several of us are sure he was able to figure out patient names with the help from one of the forum members.

Is this doctor within his legal rights to drop patients one by one over a forum post?

Thank you.

 

[SingleMom81]

Welcome to the Medical Board of California - Terminating/Severing Physician/Patient Relationship

According to that, which says:

Although a physician is allowed to sever or terminate the patient/physician relationship, in order to avoid allegations of patient abandonment (unprofessional conduct), a physician should notify patients of the following in writing when the physician wishes to discontinue care:

-The last day the physician will be available to render medical care, assuring the patient has been provided at least 15 days of emergency treatment and prescriptions before discontinuing the physician's availability.
-Alternative sources of medical care, i.e., refer patient to other physicians, by name, or to the local medical society's referral service.
-The information necessary to obtain the medical records compiled during the patient's care (whom to contact, how and where).

It would seem to me that it is, in fact, patient abandonment. He cannot just drop his patients immediately, or over the phone.

 

[barry1817]

patient abandonment

Hi,
This is regarding a possible patient abandonment in California.

A doctor treating patients (in a special field) visited a forum after being tipped off, where patients from all over the world discuss their specific treatments for this particular disease he treats.

The doctor saw a post about him. His name was not mentioned, forum rules say we are not allowed to use doctor names, but we are allowed to use initials, i.e., Dr. D.

The main question in the post was asking a new patient asking how to get a hold of this Md - as his office never answers the phones, you can only leave messages, often mailboxes are full and you cannot leave a message. It was urgent as a patient needed to cancel an appointment or get fined by the MD $100 if not done within one week of the appt. So she posted where she knew other of his patients would be and hopefully could help.

Many responses were negative such as "don't bother, I am feeling worse since seeing this Md", "their office is chaotic and they never answer phones or return calls" ...etc. 30 posts in all 75% warned it was like this all the time and there is no way to get through. Really idle patient to patient chatter.

The Md (we believe) was notified by a patient at the forum that HE was being discusssed in the forum. He apparently then visited the forum and was able (I don't know exactly how) to figure out the patients names...some members use their first name as their "user id".

He called several of the patients that had responded to the post and told them he didn't appreciate that they were discussing him, he was angry at the patients for saying "the office was chaotic" etc., and told them they were no longer welcome at his practice and dropped them on the spot. One girl asked that he please allow her to see him one last time to go over lab results, he said, "No find another doctor". This is a disease that is very rare and find a good specialist in the field is very difficult. When you are lucky enough to find a doctor who treats this disease there are often months to wait for new patients to get in. This doctor is well aware of that fact.

Several of us are sure he was able to figure out patient names with the help from one of the forum members.

Is this doctor within his legal rights to drop patients one by one over a forum post?

Thank you.

I would be calling his state's medical board to discuss this matter and to file a complaint immediately. I would then suggest a visit to a malpractice attorney to discuss this, the possible harm that could occur, and the need to have this well documented.

 

[lealea1005]

If you can never get through and must leave a message on a machine, how was the patient able to speak directly with the Doc?

Physicians have as much a right to protect themselves, their practices, and their reputations as those patients have the right to complain about him on the forum. It's really not that hard to figure out who the patients are, & I really don't know why you're so surprised to be exited from his practice.

I do agree that he needs to send letters to those patients and must offer emergency treatment for 15 days which normally gives enough time to find another Physician. Going over lab results is not considered emergency treatment.

His medical board will also hear his side. The complaint will result in his getting a written reminder of the steps to terminating a patient and the patients getting the exit letters. That's all.

 

[barry1817]

patient abandonment

If you can never get through and must leave a message on a machine, how was the patient able to speak directly with the Doc?

Physicians have as much a right to protect themselves, their practices, and their reputations as those patients have the right to complain about him on the forum. It's really not that hard to figure out who the patients are, & I really don't know why you're so surprised to be exited from his practice.

I do agree that he needs to send letters to those patients and must offer emergency treatment for 15 days which normally gives enough time to find another Physician. Going over lab results is not considered emergency treatment.

His medical board will also hear his side. The complaint will result in his getting a written reminder of the steps to terminating a patient and the patients getting the exit letters. That's all.

Dismissing a patient usually implies giving a patient enough time to find a doctor to continue care in an orderly manner. In a specialty that is noted, with few specialists, there is an added burden of time to allow for this. But I would also call it patient abandonment if one can't reach the office and if phone calls aren't returned. Will be up for the medical board, and if it one case it migt be a slap on the wrist, if it is a larger volume, there are problems that might be going on that might require a closer look.

 

[lya]

Welcome to the Medical Board of California - Terminating/Severing Physician/Patient Relationship

According to that, which says:

It would seem to me that it is, in fact, patient abandonment. He cannot just drop his patients immediately, or over the phone.

Oh, yes; he/she can.

The text you referenced does not say that a physician is mandated to provide written notification to a patient(s) of his/her termination of physician services. It states that to avoid ALLEGATIONS of patient abandonment, a physician should issue written notice. "Should" is a perogative usage; it is not the same as the word, "shall", which is a directive.

From what the OP presented as "evidence", no patient abandonment occurred. The physician has not refused to see any patient experiencing an emergency situation, has not failed to make a referral for any patient who needs such, and has not refused to see/treat any patient with a untoward change in condition within 15 days of being notified of termination of services.

Contacting the Board of Physicians with this Mickey-Mouse complaint is a waste of the Board's time and money.

 

[lkc15507]

You know, I have thoughts about the abandonment issue by the physician, and I'm not convinced that in all cases described his behavior meets that definition. But, I don't even want to go there because as a health care professional, a registered nurse, and a good one, even if I do say so myself, my suggestion is that all of you, the patients, dump this charlatan as a physician. For those he dumped, I say thank God, good riddance and find yourself a real doctor. For any who ask, I will explain myself further. But, this guy does not deserve to have a client base at all. lkc15507

 

[lealea1005]

You know, I have thoughts about the abandonment issue by the physician, and I'm not convinced that in all cases described his behavior meets that definition. But, I don't even want to go there because as a health care professional, a registered nurse, and a good one, even if I do say so myself, my suggestion is that all of you, the patients, dump this charlatan as a physician. For those he dumped, I say thank God, good riddance and find yourself a real doctor. For any who ask, I will explain myself further. But, this guy does not deserve to have a client base at all. lkc15507

OK, I'm game.

 

[lya]

OK, I'm game.

Just you wait, Henry Higgins..just you wait. lkc has returned.

 

[lkc15507]

Just you wait, Henry Higgins..just you wait. lkc has returned.

I'm not quite sure what that means. But, here we go. (Should I know either of you by other names?)

Okay, I'll play too. I'll reference the posters description of how the physician office answers calls. HUMM. Not professional.

Now I'll reference that the physician phones patients because he's miffed and proceeds to tell them they aren't welcome. HUMM. Not very professional.

Especially if this is all over forum posts.

Lastly, purely supposition, but I suspect that by the "online" happenings in this post, combined with the above, this physician is operating online and attempting to profit by duplicity. I suspect our poster's physician is a charlatan taking advantage of vague symptomatology to diagose folks over the internet with any number of possible conditions such as lyme disease, bruceollisis, erlichiosis, etc etc etc. My suppositions are based on daily encounters with charlatans that use these methods. What our poster describes is the epitome of the new era of online charlatans.

Even if this last paragraph of suspicion is wrong, what our poster stated makes this guy completely unprofessional at the least, even if he is not a charlatan taking advantage of patients' vulnerabilities. If even that is wrong, I will suggest that he is anything from ineffectual to incompetent as a physician if he / office staff will not even answer the phone. Any of you who wish, go to this guy for advice and / or care. I'll keep my money and my health by seeking true, knowledgeable professionals.

To our poster, you don't mention the condition, I suspect you are being duped and should get yourself to a credible, licensed, reputable, evidence based, physician now. lkc15507

 

[lealea1005]

I'm not quite sure what that means. But, here we go. (Should I know either of you by other names?)

Okay, I'll play too. I'll reference the posters description of how the physician office answers calls. HUMM. Not professional.

Now I'll reference that the physician phones patients because he's miffed and proceeds to tell them they aren't welcome. HUMM. Not very professional.

Especially if this is all over forum posts.

Lastly, purely supposition, but I suspect that by the "online" happenings in this post, combined with the above, this physician is operating online and attempting to profit by duplicity. I suspect our poster's physician is a charlatan taking advantage of vague symptomatology to diagose folks over the internet with any number of possible conditions such as lyme disease, bruceollisis, erlichiosis, etc etc etc. My suppositions are based on daily encounters with charlatans that use these methods. What our poster describes is the epitome of the new era of online charlatans.

Even if this last paragraph of suspicion is wrong, what our poster stated makes this guy completely unprofessional at the least, even if he is not a charlatan taking advantage of patients' vulnerabilities. If even that is wrong, I will suggest that he is anything from ineffectual to incompetent as a physician if he / office staff will not even answer the phone. Any of you who wish, go to this guy for advice and / or care. I'll keep my money and my health by seeking true, knowledgeable professionals.

To our poster, you don't mention the condition, I suspect you are being duped and should get yourself to a credible, licensed, reputable, evidence based, physician now. lkc15507

I don't think you thoroughly read the first post. The Physician was alerted, supposedly by another patient, that negative things were being reported about his office and his care on the internet.

He, APPROPRIATELY, was concerned for his professional reputation and his practice viability, both of which can be damaged by the comments. The Doctor/Patient relationship was compromised when the, apparently easily identifiable, PATIENTS chose to write negative comments on a public forum. The only issue I can see is whether he properly informed his patients via letter, that they were exited from his practice, giving them the 15 days to find another Physician.

Does his front office staff in need further training on prioritizing phone calls and patient problems? You bet. Does exiting a patient that, in his eyes, becomes a liability make him a charlatan? Absolutely not.

The LEGAL answer to OP's question is, YES, the Physician is well within his rights to dismiss the patient from his practice.

Your suppositions are just that.