Is this Patient Abandonment?

[knmeye011]

KY -
I have been seeing a psychiatrist for over three years for PTSD, Dysthymia (depression) and Anxiety. My physician has been very helpful to me in directing me to disability offices and helpful with the many accommodations I am now afforded because of my diagnosis. However, over the last three years, because of the ongoing depressive cycles, I have missed appointments. While this has never been addressed before, my physician has recently chosen to do so.

I missed my last two appointments and am currently in the full throws of a major depression. I called my physician for advice as many other areas of my life are crashing down on me because of the depression and feel I am in somewhat of a crisis situation. He was very angry with me for having missed the appointments. He asked for my address, apparently so he can send me some kind of contract he wants me to sign and give notice of termination. He has told me that my refusal to sign the contract (which I have not read yet) will result in termination of his services. I am assuming from what he told me it will indicate if I miss further appointments he is planning to terminate.

However, I am guessing this as he could have already made this decision. He told me he would help to find another doctor. Because I am currently not working and he agreed to a very reasonable fee ($100 a session) there is NO WAY I will be able to find another physician who can accommodate me. I have no health insurance. I have very little money right now because I am out of work. And I am fighting a depression which is adversely affecting my educational goals.

That's my case. Here are my questions: Do I have to sign another contract with him? If I refuse, can he terminate the care? Can I refuse temporarily to sign because I currently do not feel Im in any shape to be signing contracts? I have an appointment with him tomorrow and instead of focusing on the care I need right now, apparently I am going to have to mull over a contractal obligation. My last question is this - because I am in somewhat of a crisis - do I have a right to ask him not to push me against the wall with this right now - but perhaps come back to it later? I've always paid him, even for the missed visits - so I hoping this affords me some degree of protection.

Thanks for any advice.What is the name of your state (only U.S. law)?

 

[lya]

Whether or not you sign the contract is your choice, just as it is the physician's choice whether or not to continue you as a patient.

In no way has the physician abandoned you as a patient. If the physician refuses to see you, again, he/she still has not abandoned you as a patient.

 

[knmeye011]

Response to Advice

I suggest that you read the following article, especially if you are in the health care industry, as you profile indicates. I do not think you answer adheres to the law. This belief is based on what I have researched on the matter and may be in error. However, because you answer fails to indicate any type of detail or logic other with its simplicity, it is hard to refute the grounds on which you base the answer you have given.


When a physician may refuse to treat a patient

 

[Zigner]

I suggest that you read the following article, especially if you are in the health care industry, as you profile indicates. I do not think you answer adheres to the law. This belief is based on what I have researched on the matter and may be in error. However, because you answer fails to indicate any type of detail or logic other with its simplicity, it is hard to refute the grounds on which you base the answer you have given.


When a physician may refuse to treat a patient

Nice article.
Now, what was your problem with lya's answer?

 

[Some Random Guy]

The article you posted gives non-technical explanaitons of the applicable laws and provides what the author considers to be guidelines for when it is acceptable to terminate the doctor patient relationship. These are one person's guidelines and not the law.

It seems your doctor has already done a great deal to keep this relationship alive despite your inability to pay standard rates or keep appointments. They are providing you notice that you should seek other doctors and are not discriminating against you because of your disability. If anything, they are accomodating your disability since most other providers would not have let the situation go on this long.

 

[lya]

However, because you answer fails to indicate any type of detail or logic other with its simplicity, it is hard to refute the grounds on which you base the answer you have given.

Sweet.....

 

[lealea1005]

Ohhhh...you want logic and detail???

OK: You are a non-compliant patient who misses appointments, then calls the Physician when you are in crisis, wanting him/her to treat you over the phone. In Doctor-speak: BIG RED LIGHT! He's (rightfully) covering his behind, because he recognizes that you are attempting to manipulate him and, therefore, your treatment.

If you're so quick to want to sue him for requiring that you sign a contract, then I can only imagine the dust trail you (or your family) would leave to find a lawyer willing to bring suit against the Physician because you caused harm to yourself or some one else.

LEGALLY speaking, YOU compromised your care, and the Doctor/Patient relationship, by being non-compliant (missing appointments). He voiced his concern to you regarding the situation via telephone, and is now requiring a signed contract to insure continuity of your care (aka: wake up call to you, the patient). I think he's being generous if he agrees to continue your care within the guidelines of the contract. His only "duty" at this point is to give you 30 days notice to treat you on an EMERGENCY basis only. That will give you more than enough time to find another Physician in your area.

 

[longsally111]

Love your post lealea, really. I could not have said it better.

 

[Dougthegreat]

That's my case. Here are my questions: Do I have to sign another contract with him?

No.

If I refuse, can he terminate the care?

Yes.

Can I refuse temporarily to sign because I currently do not feel Im in any shape to be signing contracts?

You can refuse to sign because you woke up and saw a purple moon. Your motive is irrelevant; however, he does not have to continue to treat you.

I have an appointment with him tomorrow and instead of focusing on the care I need right now, apparently I am going to have to mull over a contractal obligation.

You mentioned 'another' contract, and I'm guessing you didn't hold up your end of the 'contractual obligation' before. Feeling sad is not an excuse.

My last question is this - because I am in somewhat of a crisis - do I have a right to ask him not to push me against the wall with this right now - but perhaps come back to it later?

Sure do. And he has the right to tell you to take a flying leap... well, maybe not so literally as a shrink, but you get my drift.

I've always paid him, even for the missed visits - so I hoping this affords me some degree of protection.

Good news! It does - specifically, from debt collectors.

 

[TheGeekess]

And just to add, if the physician does decide to no longer treat you (which is his right with a non-compliant patient), call a mental health center that is local to you to insure "continuity" of treatment (which, again, if you're missing appointments with the psychiatrist, then you're not interested in continuity). Just out of curiosity, how many Axis II diagnoses do you have? I mean, you've listed the Axis I diagnoses...