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July 23rd, 2008

patient abandonment

There have been some blogs and some NYT articles about "firing" patients for a variety of reasons (pain in the ass, parent of juvenile patient is pain in the ass, noncompliance, payment via medicare/medicaid/other voucher/etc.). These kinda bother me, especially if we're headed towards an era of "pay for performance" where practitioners are required to get all their patients LDL under some number through use of statins or whatever, and the practitioner might be motivated to fire patients who aren't playing along.

While I was looking around the ICAN website, I stumbled across the term "patient abandonment" and googling found me this summary (written by lawyers!):

http://www.gilliland.com/CM/Articles/PatientAbandonment.asp

The executive summary seems to be this bit:

"Three elements must exist for patient abandonment to occur:

1. The termination of services must be unilateral, i.e., not by mutual agreement.
2. The termination must occur without reasonable notice, meaning notice adequate to give the patient a sufficient opportunity to secure alternative care; and,
3. The termination must occur when there is still the necessity of continuing care."

Wow. Who knew? Well, _I_ didn't know. And it goes a long way to reassuring me that as a patient/client, I do in fact have some rights. Even people living in areas with just a single doctor should be able to coerce that doctor into providing care (treatment? care seems wrong in this context) even if the doctor has taken a disliking to them -- provided they can find a lawyer somewhere to write pointed letters, possibly followed up by a malpractice lawsuit.