Should doctors be able to fire patients ?

Doctors don’t much like the idea of patients rating them online and they don’t like the idea of their ratings being tied to their payments.  Should doctors, though, be able to fire patients who don’t follow treatment recommendations and continue to endanger themselves with unhealthy lifestyle choices ?

According to an article in this morning’s Wall Street Journal “Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are “firing” such families from their practices, raising questions about a doctor’s responsibility to these patients.”

In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason.

So then what happens to patients who are on the road to preventable diseases like Type 2 diabetes, high blood pressure and cholesterol because they either refuse to make lifestyle adjustments or feel they don’t need to because “there’s a drug to treat it” ?

One option which I am in favor of is that people who make bad lifestyle choices which in turn leads to bad health, and increased costs, should pay higher healthcare insurance premiums.  Eventually that should convey to them that need to take control of their health.

Another option might be a HCP who communicates that he, or she, will no longer treat that patient.  It’s a big step and I am sure there are a lot of arguments both ways but how else can HCP’s convey that patients are potentially killing themselves by poor health choices ?

Let’s also be clear here I am talking about patients who refuse to make the voluntary choices they need to make to get healthy. I’m not talking about patients who cannot afford medications or visits to the doctor.  That is a separate issue that needs to be addressed via more free drugs to those that can’t afford it.

Related articles

• Patients in the waiting room do not know why doctors are running late (kevinmd.com)
• ‘Symptoms and Diagnosis’ Book Project to Feature Real Patient Cases (prweb.com)
• Survey shows disconnect on end-of-life health care (sfgate.com)
• Doctor & patient (thehindu.com)
• Is your doctor lying to you? New study says it’s likely (cbsnews.com)
• Is It O.K. for Doctors Turn Away Unvaccinated Kids? (parenting.blogs.nytimes.com)