The doctor patient relationship always toes a very fine line. Some patients can be incredibly picky and some doctors can be extremely demanding. These are the instances in which doctors or patients have had to end their relationship, and how these breakups transpired.
"I have 'fired' two patients in my career.
The first was a family of a man about to have a planned surgery. They were upset that they had to wait until the following week to see the cardiologist, and because of their influence, they called their State Representative. He called the hospital CEO, who called me. I explained the situation then called the patient and told him that trying to force the system to work solely to his advantage was not how this was going to work. I explained that the doctor-patient relationship in non-life threatening situations is voluntary and gave him a list of other specialists in our area.
The second patient had a wife who was very mean to my staff over several visits. In their last visit, she made my lead nurse cry and actually hit one of the techs as she was helping the patient put a sock back on. The patient made no apology for her, supported her actions, and seemed to think that this was normal behavior."
"I was the fired patient. Well, I sort of quit anyway.
I had quite a bad dentist at 13 who would just not listen to what I had to say. One time, I had a cavity on one of my molars. Asked for an anesthetic like I always did for years with all my previous doctors (my pain tolerance is low when it comes to teeth). She didn't want to give me an injection but I insisted, and she finally gave me a dose that was way too small. And instead of waiting the usual 10 minutes for it to kick in, she started drilling immediately.
Of course, I screamed in pain and nearly stabbed myself with the drill because I got so startled. She yelled at me for being a baby and said I'm exaggerating, 'it doesn't hurt at all!' I got defensive and asked her if we could wait until the anesthetic makes it numb, but she didn't want any of it. I laid back on the chair and reluctantly agreed to go on, but as soon as the drill touched the tooth, I wanted her to stop because it hurt like crazy. She just told me to stop whining.
Then I screamed bloody murder for her to stop again. When the instrument was out of my mouth I stood up. 'Can you hear me?! I told you it REALLY hurts!' She got super offended, but I didn't let her speak and told her to just give me a temporary filling and I'll be getting a new dentist who cares about their patients.
A few days later I wrote her a letter of apology because my mom wanted me to. I admitted that I overreacted but I let her know that patients are people to be considered, not ignored when they're screaming in pain."
"When I was a paramedic, a call came in that a child was suffering from a severe peanut allergy. She was seven and her older brother thought it would be funny to force-feed her peanut butter. Either way, get her loaded in, but the mom was just dragging her feet. She forgot her purse, then her phone, then her brush, then her gum or whatever.
I just sort of waved at her, 'Hi…….We need to go the hospital now……Child……Sick…….Hospital……Let’s freaking go!'
So, she waddled her way over to the ambulance and gets in. It took about three minutes before her phone is out, and she snapping pictures of her daughter for her Facebook page. One of those, 'Like to make my baby better!' things.
So once again, I just sort of wave at her, 'Hi………Please stop……We’re trying to help your daughter…….'
She ignored me and took more Facebook or Twitter pictures. Click, click, click. I just lost it. 'STOP. Taking. Freaking. Pictures. You dummy!' Then I took her phone away.
So, now the mom was flipping out because I took her phone away. We got to the hospital and the mom was still flipping out over her phone being confiscated. People at the hospital thought she was distraught over her child and tried to calm her down, they figured out it was about her phone being taken away by the mean man in the ambulance.
They quarantined the so called 'Mom' in the waiting room until she calmed down about her phone. Hospital security came to me, got her phone back and she was allowed to go in and see her daughter, provided she stopped taking pictures of her daughter and instead try to comfort her.
Click, click, click. 'Like to save my baby!' Click, click, click. Then I hear the attending M.D. just explode, 'Okay, get the heck out! Just get the heck out of this room!'
I guess that would count as being fired.
Yes, I did get in trouble. I got what was called a 'note to file' or 'semi-final', I'm sure the term is different for different places. What that means was I had to sit down and speak with my supervisors regarding the incident. But that was because I took her phone, not because I called her bad names. Yes, Doctors can ask people to leave if they are being disruptive and they are trying to do their job. Yes, they can say, 'get the heck out'. Especially if someone's life is at risk."
"I was a patient that was fired... kind of.
I was bitten by a spider. Possibly a brown recluse. It turned into a nasty staph infection that caused me to be hospitalized. I am also a diabetic.
While under the hospital's care, I was told I was not allowed to manage my own diabetes. Which I'd understand, if they managed my diabetes. But they didn't. Not in a good way at least.
I called for a nurse to check my blood sugar, because I knew it was high. Like, way high. Previously, they had been ignoring me, but I demanded a nurse to check it. 425. It should be between 90 - 120. I ask for insulin (to bring it down to normal ranges). I'm told that they will not give me insulin until food is in front of me. For those not in the know, food RAISES blood sugar.
As a diabetic, you are told that if your blood sugar reaches these levels that you should seek medical attention at a hospital... and here I am, in a hospital, and being told 'Nope.'
An hour later, the food lady comes. The nurse checks my blood sugar. 560. 'Oh gosh, we should get you insulin!'. No. Freaking. Clue. Why are you surprised?!
I yelled at them. I then called my endocrinologist (the Doctor who manages my diabetes). He yelled at them. They were not happy. I was not happy.
Later, I was dismissed without pain medications. Mind you, I had just had surgery in which they left me with a wound in my thigh that had to be packed daily with gauze. It was about 1 inch (circular) and deep enough to almost reach the bone."
"I was dumped by my first obgyn. After I had my daughter I needed to research my birth control options because I still got pregnant on the pill. He gave me the Depo shot without my permission, like they told me it was something else.
So my next appointment I got the nurse practitioner and the doctor and I was like 'I was interested in this..,' and she goes,
'Oh no, you got the shot' and I was like, 'No, I said I didn't want that. I don't want the Depo, it will mess with me.'
She looks at the chart and sees my consent was never signed and the Doctor tells me I need to sign it and I refuse. I was angry but I was 17, I didn't know just how bad I had been worked over. My next appointment it was just him and he basically told me to find a new OB/GYN. Looking back I would have pitched a huge fit but being young I didn't know any better."
"I'm a Dentist.
One time I refused to see a patient after they refused to stop chewing gum. I mean, during the appointment. I asked her three times, and every time she pretended to take her gum out. Which, at 16 years old, seemed pretty childish.
I finally worked on her, and as I took my hands out of her mouth for an instrument, she started chewing again. It was STILL in there.
I told the parent that their daughter was not ready for braces. They argued, but she would not follow the simplest instructions, let alone habits she would need to form to keep her teeth clean throughout treatment."
"I've fired a number of patients, and likewise been fired. Sometimes it just doesn't work out. For one of my colleagues the 'last straw' was having the patient break the exam room wall with her head and then leave screaming obscenities at her. I actually chased that one out myself (falling glass on the other side of the wall almost hit my own patient). First patient I ever fired myself tried to destroy her own medical records.
A wise doctor I knew early in my training once said, 'the only things I'll fire a patient for are physically abusing me, abusing my staff in any way, or calling me at home.' Seems about right."
"I'm a nurse practitioner.
In my area and because we are an urgent care, we get a lot of doctor shoppers but in California we can look up the narcotics record so at least once a day we will tell the patient that it seems like they are fully stocked from another doctor and that they are not going to get anymore. Usually they will be resigned but sometimes they will get super defensive. There is a mother and son that stole the main doc's DEA number and called in poorly worded narcotics on an elderly person. We fired them so bad that we turned them in to the police."
"Not the doctor, but I am the girl that writes the 'you're fired' letters to the patients.
In the past four years I've probably written something like 40-50 letters. Most are people on narcotics that have come up positive for other substances multiple times (my doctor is nice and likes to give people second, third chances). Other times it's for doctor shopping or seeing multiple doctors for the same issue. Some are for multiple no shows or cancellations (most recent had 64 cancellations in three years). The rest are due to bad behaviors.
One was calling the doctor and practitioners horrible names in the waiting room to other patients. Another screamed at everyone in the facility because she had history of filling meds early, and we refused to give them to her early anymore. Another kicked out our glass door because we wouldn't give her narcotics (she wasn't even prescribed them). Another called over 25 times in one day just straight up harassing us because we wouldn't help her commit fraud.
There's lots more. These days though, we don't have to write letters most of the time. They get blocked due to non-payment of their bills. Once they're blocked they can't make appointments and without appointments they get no meds. So suffice to say this has caused a lot of drama lately.
"I was the one that got fired. Long story, but I was having problems for about six months and was sent to the neurologist in my small town. When I got there the doctor didn't have any of my files and straight up told me so.
I told him what was going on, and he prescribed me three separate pills for headaches insomnia and nausea. Well I researched these pills before I picked them up and decided not to take them. It would have masked my symptoms and I thought I wouldn't get a diagnosis.
I saw him after another MRI and told him I didn't get the pills he prescribed. He told me I needed to leave because he wasn't going to give me oxytocin. I tried to tell him that's not what's going on I just wanted to know what was wrong with me. But he had no cares to give.
Three months later I was diagnosed with a somewhat rare malformation and large cyst in my brain. I have neurosurgery in November.
We plan to sue the doctor for malpractice but I'm waiting until after recovery to talk to a lawyer."
"My wife was 'fired' from her psychiatrist recently. After more than a year of switching medications and adjusting dosages she is finally on the right medication and lives a pretty normal life. The trouble started when her original doctor retired and someone new came in to take over his spot.
The new psychiatrist immediately changed all of her medication telling her I don't believe that you are this bad and you shouldn't be taking all of this medication. Trying to work with the new doctor my wife tries the new medication and after a few weeks its obvious that things are getting worse not better. She goes back and pleaded with her to put her back on her normal meds that she can't function with the new ones. The doctor refused, she said that if she (my wife) didn't like her new medication she can leave and never come back.
Thankfully, we found another psychiatrist that listens and has worked with my wife to get her on the medication she needs."
"My family ended up firing our dentist. When I was about 7 or 8, my dentist explained that my teeth were coming in too fast, and it would be beneficial to pull four of my baby teeth to make room. I think this is fairly common? My mom asked me later if I would like to be 'put to sleep.' Having had pets my whole, short life, I knew what that meant and vehemently said no (honestly that she asked so carelessly scared me deeply at that age). She nodded her head thinking nothing of it and scheduled the appointment.
The dentist proceeded to pull four teeth that were not anywhere near loose out with the equivalent of pliers and NO ANESTHETIC of any kind. I'll never forget the mind searing pain or the cracking sounds that accompanied this whole process. His explanation when I ran into my mother's arms and burst into tears in the waiting room? 'I don't understand the problem. Children cannot feel pain.'
"I got 'fired' from my pain doctor.
I didn't like her from the start and we clashed personalities at every visit. I made the mistake of telling her once that I had some meds left over, and she FREAKED - told me maybe I didn't need pain meds after all, blah blah blah. So when I had extras I never told her again, until she changed my dose on me without telling me.
I would put the scripts to be filled on the fridge (so I wouldn't lose them) and would take the next one in line to get filled - until I got the wrong dosage and contacted her. She flipped her lid (again, I had NO idea she changed my dosage) and made me go in to her office. I am a 45-year-old woman and I refuse to be talked to like a child. When she confronted me I told her she never told me she lowered my dose (if I had known that, I would have ripped up the other scripts and flushed them) and she insisted she did. My significant other was with me every single appointment, and he didn't hear it either - if it was just me I could see me making a mistake.
Long story short I found a new pain doctor, and I am off the medicine the awful pain doc gave me so much grief for & I really want to call her and tell her how well I am doing off half of the pills she was giving me (I never had a 'dirty' urine test, never missed an appointment, and never begged for early refills and yet she treated me like an addict from day one).
"My friend is a pediatrician, and specializes in the care of children with ADHD.
An 18-year-old came in for his medication check and refill. He told the doc that he only uses his Ritalin before a test so he could have an 'edge.' He doesn't need the Ritalin for anything else. The doctor refused to refill his medication, on the grounds that it didn't appear he had ADHD and was just abusing the Ritalin for personal gain.
The next day, his mother came and started to demand to see the doc. She was Korean. When the doc sat with her, she started yelling at him telling him that if he didn't prescribe the Ritalin, she would sue him. She said that her son needs the Ritalin since he just got into med-school (a special 6-yr program in Ohio), and she wanted to be sure he did well on his tests. The doc told her that he didn't feel comfortable prescribing a controlled medicine like Ritalin to someone who was using it just for an edge during exams. She kept yelling. The doc eventually told her to go find another doc."
"This happens on a daily occurrence for some of us. It's also a touchy subject, because it touches on the principle of abandonment (we're supposed to make sure someone always has access to care).
That said, it happens quite regularly for all physicians (with the possible exception of ED docs for the reasons above, but departments have other ways of protecting staff from abusive patients). I wish I could tell you a great story for most of these, but the truth is that like many jobs ours is full of banalities you don't see on TV. We've all had 'crazy' patients, but the vast majority are removed from practice for bland reasons.
In the ambulatory setting, the most common reasons include repeatedly failing to show for appointments on time, prescription substance abuse, and failing to pay. The inpatient setting is different, as you have to have a certain acuity of illness to be admitted, but the most common reasons there are more related to abuse of staff and refusal of care.
Then there's the areas of interesting controversy. What if your patient refuses a vaccine? Providers and patients give dramatically different responses to that one. Happens around 6-30% of the time according to a recent AAP article. Another example, one concern about the increasingly-popular 'pay for performance' model, where 90% of your diabetics need to be well-controlled for reimbursement, is that it might create pressure to fire those pesky milkshake addicts."
"There are only a few things that will get a patient fired. Verbally abusive with my staff. I have zero tolerance for this one. A patient can get mad at me and yell at me all day long. I can take it. My staff is different. They don't get paid to be abused. Period I will always stand up for my staff. Chronic no call no show. 3 in one year and you are out. I have a 3 month wait list. I will keep my spots for patients who want to come. Other than that, there are patients where we mutually agree to disagree and we part ways amicably."
"Once a year, my mother sits down with her big list of area pharmacies and calls them all; she usually finds out a few people are doctor shopping, and one time she actually discovered someone had been altering/forging her prescriptions. She writes these people a letter to formally 'fire' them.
For those of you curious or skeptical about this: She works in a rural clinic and there are ~20 area pharmacies tops. She doesn't have hundreds of patients nor are there a ton of places to fill a prescription. She also doesn't ask about every single patient; just a handful of ones who are on pain meds. My mother would never be able to operate a database or keep an Excel sheet. She's a bit of a luddite; it's a phonebook, pen and paper for her. It doesn't take as long as you'd think. She's on the phone maybe 10 minutes/pharmacy and she usually does the whole thing on a Saturday afternoon.
I agree, it's not efficient, but my mother is a rural solo family practice doctor and things work a little differently than they might in a suburban or high-volume practice. Prescription abuse is a huge problem in her practice, and she's gotten burned enough that she decided to find some sort of solution. It works for her."