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  • Patient termination

    A patient no shows too may times and is sent a discharged from practice letter and allowed to use the practice for 30 days for urgent medical needs.

    A patient is verbally abusive to several staff on the phone (yelling and swearing) Obviously the patient will be let go but do you give them the 30 day window?
    Anyone actually know what is legally required and where to find such laws?

    Thanks

  • #2
    Think it’s by state under patient abandonment.
    https://www.nolo.com/legal-encyclope...andonment.html
    Good luck.

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    • #3
      https://www.physiciansweekly.com/avo...r-termination/

      Presumably state specific somewhat

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      • #4
        Good grief. More so than any bureaucratic hurdles, it is this kind of nonsense that drives me nuts. A patient comes to the ER/office, gives a fake address, takes your services with no intention to pay. If they did that in a grocery store, do you know what that is called? Theft. A patient comes to your office swearing and causing a ruckus. Do that in the grocery store? It is called assault/trespassing.

        But in medicine, for some reason, this kind of behavior is legally protected. Patient abandonment? Give me a break.

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        • #5
          Originally posted by G View Post
          Good grief. More so than any bureaucratic hurdles, it is this kind of nonsense that drives me nuts. A patient comes to the ER/office, gives a fake address, takes your services with no intention to pay. If they did that in a grocery store, do you know what that is called? Theft. A patient comes to your office swearing and causing a ruckus. Do that in the grocery store? It is called assault/trespassing.

          But in medicine, for some reason, this kind of behavior is legally protected. Patient abandonment? Give me a break.
          That is my opinion as well but my legally scared admin overlords have a different opinion.
          I personally do not mind sucking it up and letting someone yell at me if I know if it keeps us on firm legal ground and it will end in 30 days but I do not want to subjest my staff to this. They do not get paid enough to be cursed at.

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          • #6
            Originally posted by Lordosis View Post

            I personally do not mind sucking it up and letting someone yell at me
            We are such good little lemmings.

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            • #7
              Originally posted by G View Post
              Good grief. More so than any bureaucratic hurdles, it is this kind of nonsense that drives me nuts. A patient comes to the ER/office, gives a fake address, takes your services with no intention to pay. If they did that in a grocery store, do you know what that is called? Theft. A patient comes to your office swearing and causing a ruckus. Do that in the grocery store? It is called assault/trespassing.

              But in medicine, for some reason, this kind of behavior is legally protected. Patient abandonment? Give me a break.
              The amount of assault/battery that happens in an ED that goes unreported/unprosecuted is depressing. I have a very low threshold for discharging and having these patients escorted off the property. Just because you’re in the ED doesn’t mean laws and/or societal decency doesn’t apply to you. I’d rather take my chances amongst a jury of my peers than have a staff member verbally, emotionally, and/or physically assaulted and abused.

              Comment


              • #8
                Originally posted by CordMcNally View Post

                The amount of assault/battery that happens in an ED that goes unreported/unprosecuted is depressing. I have a very low threshold for discharging and having these patients escorted off the property. Just because you’re in the ED doesn’t mean laws and/or societal decency doesn’t apply to you. I’d rather take my chances amongst a jury of my peers than have a staff member verbally, emotionally, and/or physically assaulted and abused.
                I imagine you guys in the ED get it way worse then us office based folk.

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                • #9
                  "a staff member verbally, emotionally, and/or physically assaulted and abused" This is a real risk.
                  I have noticed a much more significant presence of security in medical office buildings and individual suites as well.

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                  • #10
                    We discharge patients for abusive language, threatening behavior, and the like approximately once per month. We have only needed the police on one occasion. We have security doors and glass installed for this reason. It's insane that we need it, but we do.

                    Most common reason for issues is when a new patient shows up 30 minutes late, typically because he or she "couldn't find the office," and hasn't done the new patient paperwork available online. They are told they may not be seen but we will try to work them in the schedule since they missed their appointment time and still have paperwork to fill out. They get all worked up into a lather about how they took time off work or drove 20 minutes to get here. Like it's our fault they didn't leave on time, or use Google Maps, or fill out the paperwork ahead of time. I'm always amazing how patients thinks it's no big deal to show up late. It's like they expect the airplane to wait for them at the airport or the movie to be restarted if they're late to the theater.

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                    • #11
                      As a general rule curse at my admin staff or threaten to sue and its curtains. I provide 30 days worth of meds and a list of local practices.

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                      • #12
                        I hate when they use the idle threat that they are going to change doctors. In my experience those who threaten it stay. Those who leave usually do so quietly.

                        ​​​​​​

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                        • Eye3md
                          Eye3md commented
                          Editing a comment
                          And patients like this, who get upset over problems they created themselves, are the ones I never mind losing. A small percentage of patients seem to create the most headaches, and I really don't care if they like me or not

                      • #13
                        Originally posted by Lordosis View Post
                        I hate when they use the idle threat that they are going to change doctors. In my experience those who threaten it stay. Those who leave usually do so quietly.

                        ​​​​​​
                        Kind of like the people that tell you they're going to sue you or that they're going to call their lawyer right then and there. Ok, be my guest, but you'll have to do it in the waiting room.

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                        • #14
                          Being sued by your staff for allowing them to be physically/mentally/emotionally assaulted is far more likely & damaging than "abandoning" a problematic patient who's behavior others can attest to in court.

                          I'd cut them loose immediately, document in the chart the "need" to have them let go immediately, that they have no current issues except "ongoing non-emergent or urgent diagnoses", & an adequate supply of any medications you prescribed, or that "a 30 day refill will be called/faxed to the patient's pharmacy".
                          $1 saved = >$1 earned. ✓

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                          • #15
                            Definitely state specific. I remember reading somewhere that Georgia requires you to give care in emergencies for 6 months. Non-emergent stuff is immediate.

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