Can Your Physician Fire You?
Imagine this scenario: You’ve called your doctor’s office to make an appointment and are told that your doctor won’t see you. Thoughts start racing through your mind: Did I call the wrong office? Did something happen to my doctor? Or, worst of all, have I been abandoned, which occurs when a physician terminates a patient/physician relationship without following state regulations?
In the fall of 2014, a Tree of Life Health Advocates client (I’ll call Erika to protect confidentiality) was involved in an auto accident. Shortly thereafter, she tried to make an appointment with the orthopedist who had been treating her adhesive capsulitis (frozen shoulder) for two years, but was surprised to learn that her doctor would not see her. Shocked, she telephoned our office requesting help to get past the front desk gatekeepers. We wondered whether Erika could be the victim of physician abandonment.
Physician abandonment, a very serious allegation, is also a fear that haunts many patients. In California, physicians are permitted to terminate the patient/physician relationship, but they must follow a specific procedure or they can risk disciplinary action by the state Medical Board.
How I Helped Erika See Her Doctor
I called the business manager at Erika’s doctor’s office. He informed me that the practice routinely declines to treat patients who have been in accidents, even when such patients’ visits and procedures will be covered by health insurance or paid up-front. The policy exists to prevent the doctors in the practice from becoming involved in depositions, trials, and related legal proceedings, which can take hours or days out of a busy physician’s life.
Eventually, the business manager agreed that Erika could schedule an appointment with one caveat: only her pre-accident injury would be evaluated, not the injury that incurred in the auto accident. At my insistence, Erika was offered the next available appointment but she later cancelled it. After all, she already felt betrayed by her physician and wanted nothing more to do with him.
Some Intriguing Questions to Consider
While Erika’s doctor probably didn’t actually abandon her, technically speaking, his refusal to evaluate the injuries she incurred in the auto accident raises a number of serious questions. These include:
- Is this the idiosyncratic policy of one medical practice or an upcoming trend across the industry
- Does this policy constitute cherry-picking patients? Does it promote discrimination against patients with complex medical conditions or injuries?
- From a clinical standpoint, how would Erika’s physician actually have differentiated between her pre- and post-accident soft-tissue shoulder injuries?
- Is it ethical for physicians to refuse to treat patients who may become involved in legal proceedings?
- Is such refusal a violation of the Hippocratic Oath, taken by virtually all physicians, which states the obligations and proper conduct of doctors?
In the delicate negotiation of power between you and your physician, always remember that your right to receive care, while not unconditionally protected, cannot be terminated on a whim.
Finally, please remember that if you have a healthcare challenge, I want to be your advocate. To learn more about how I can help, visit my Services page.