Can a Doctor Drop a Patient for No Reason
Editor'due south note: This popular story from the Daily Briefing's athenaeum was republished on June 27, 2019.
Nine out of x practices have "fired" a patient, merely not because doctors are trying to carmine-pick patients—it's because of poor patient beliefs, according to a new study in JAMA Internal Medicine.
5 myths physicians believe nearly patient feel
Methods
For the report, researchers surveyed 794 practices, including 443 participating in the Comprehensive Primary Care (CPC) initiative and 351 practices in a comparison group. The researchers asked each do, "In the past 2 years, has your do ever dismissed a patient from your practice? By dismissing patients, we hateful directing patients to leave your practice and seek primary intendance elsewhere."
The respondents that answered "yes" were then asked to specify the reasons for the dismissal, and how many patients they had dismissed over the past two years.
Results
The researchers plant that "firing patients doesn't happen often," STAT News reports. While the majority of practices said they had dismissed at least one patient over the past two years, 67 pct of those said they had dismissed between one and 20.
Equally for the reasons for dismissal, the study found:
- 81 percent of practices that had fired patients said they did so considering a patient was "extremely confusing and/or behaved inappropriately toward clinicians or staff";
- 78 per centum said they did and then considering a patient had "violated chronic pain and controlled substance policies";
- 74 percentage said they did then because a patient had "repeatedly missed appointments";
- 45 percent said they did so because a patient had repeatedly "not follow[ed] medical recommendations";
- 39 percent said they did so because a patient had "violate[d] neb payment policies";
- 7 percent said they did then because a patient had repeatedly "not follow[ed] recommended lifestyle changes"; and
- vi percent said they did so considering a patient made frequent ED visits or self-referred to a specialist.
The researchers noted that a cardinal takeaway from the report is in that location are no signs that providers are seeking to cherry-red-choice salubrious patients and expunge those with difficult or complex chronic weather—a practise that some wellness intendance experts have feared would arise equally insurers shift from fee-for-service reimbursement to value-based payments.
"The reasons practices are dismissing patients aren't then much related to the things people were worrying nigh—that if (insurers reimburse more for) quality of care, doctors might outset cherry-picking patients," Ann O'Malley, Mathematica Policy Research senior fellow and lead author on the study, said. Rather, according to O'Malley, some of the reasons practices cited for dismissing patients were "perfectly legitimate" (O'Malley et al., JAMA Internal Medicine, 5/xv; Blau, STAT News, 5/15)
5 myths physicians believe almost patient experience
Excellent patient feel is a critical piece of modernistic medicine, reflected clearly in outcomes. And more than amenities, clean rooms, or tranquility during night, the factors that most inflect patient experience all relate to communication and coordination among the intendance squad—factors that physicians are in a unique position to influence.
Clinician-patient communication, leadership of the intendance team, and back up and empathy for the patient across the unit are the most important factors for success, and they're all driven by the physician as the "Influencer in Chief."
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Source: https://www.advisory.com/daily-briefing/2017/05/18/patient-dismissal
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