“I noticed that someone wrote in my chart that I was difficult,” character Elaine Benes said to her doctor in a 1990’s episode of the comedy “Seinfeld.”
It made for a funny scene in the iconic comedy, as Elaine tried to get the doctor to change the chart and convince him she was not difficult.
Unfortunately, in real life, it’s not so funny.
“I was angry. Very angry,” Jess Rifkin said, recalling the dismissal letter his wife Jayne received from her pulmonologist after he complained about her care.
Mrs. Rifkin had been in the hospital multiple times for COPD and her husband says he was frustrated, that the doctor wasn’t doing more to help.
“My exact words were ‘You are her doctor. Why don’t you treat her like she’s your patient? Be her doctor.’” Rifkin remembered. “He absolutely didn’t like that, and three days later, we got a letter from him dismissing my dear wife from the practice.”
Rifkin says the letter was blunt saying something along the lines: being that I cannot live up to your expectations for your treatment; we are dismissing you from the practice.
They were shocked, hurt, and did not think such drastic action was fair.
“She did nothing to offend him. She was very compliant. She did everything that he asked her to do and just from my comment, she got fired,” Rifkin said.
Little recourse for patients
Basically, doctors can fire patients for any reason they want — as long as they’re not discriminating against them or putting their health and safety at risk, but there are some guidelines they do have to follow.
“There’s a right way to do it and a wrong way to do it,” said Healthcare lawyer and medical ethicist Dr. Jay Wolfson.
Florida law makes the rules very clear. A doctor must:
- Send a formal letter notifying the patient
- Give at least 30 days notice before ending care
- Provide access to their medical records
- Suggest new providers
“They have to continue the care to the point where you are safe and where they can hand you off to one or more alternatives,” Dr. Wolfson explained. “They have to give you the names of alternative physicians. They can’t just say, ‘You’re fired. Thank you. Go home.’”
Common reasons for dismissal
Unfortunately, Dr. Wolfson says, with the growing challenges of running a doctor’s office today, especially with insurance issues, dismissals are becoming more common.
“One of the most common reasons is a personality clash between the patient (sometime the patient’s family) and the physician or the physician’s staff,” Dr. Wolfson said. “The office can very, very busy. They may not be able to spend as much time with their patients as they used to; and the patients get a little bit frustrated.”
The most common reasons doctors dismiss patients include:
- Personality clashes
- Non-compliance — or not following treatment recommendations
- Missing appointments
- Not paying your bills
- Type of insurance
What you can do
If this happens to you and you want to repair the relationship with your doctor, you can try to call the office and ask them to help you understand why you were dismissed.
“If you were responsible for causing the firing, you may want to say, ‘I’m really sorry. I had a bad day.’ The worst thing that can happen is that somebody’s going to say no,” Wolfson said. “If it can’t be resurrected, maybe it’s a good idea to get out of it.”
You can also write an online review about your doctor, explaining in a concise way what happened and why you don’t think it was fair. Doctor’s know, in the era of social media, that patients can write negative reviews, so generally they don’t make the decision to dismiss a patient lightly.
Most importantly, don’t let concern over being dismissed from a doctor prevent you from asking questions. You have to be your own best advocate.
“We encourage patients to come in with a list of questions, a list of concerns and, if they’re not answered, to give them to the physician and say, ‘When you have time, since we can’t do it today, could you find a way to answer these questions for me?’ and most physicians will,” Wolfson said.
Finding a new doctor
It is up to you to follow up with the suggested, alternative physicians or find a different one you like.
Be sure to research the new doctors well — check out the practice’s website and read online reviews.
Also, be sure to get a copy of your medical records from the doctor you’re leaving, so you don’t have to repeat tests or bloodwork you’ve already had done.
In the Rifkin’s case, they say the doctor did not offer suggestions for other doctors, which made their search for a new pulmonologist difficult, but, in the end, it did work out for the better.
“He absolutely did us a favor. Now, my dear wife has a wonderful pulmonologist,” Rifkin said.