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FamilyPhysician
FamilyPhysician, Doctor
Category: Mental Health
Satisfied Customers: 12816
Experience:  Family Physician with over 23 years clinical experience treating patients with mental health issues
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Medical Malpractice

Resolved Question:

KY -
I have been seeing a psychiatrist for 3yrs for PTSD, Dysthymia (depression) &Anxiety. My DR has helped me get help from disability offices & accommodations. However, I have missed appointments (bc of depressive cycles).

I missed/last 2 appts & am currently experiencing major depression. After notifying my DR, he was very angry and is now sending me some kind of contract to sign. He has told me that my refusal to sign the contract (which I have not read yet) will result in him "firing me".

He told me he would help to find another DR. Because I am currently not working and he agreed to a very reasonable fee ($100 a session) there is NO WAY I will be able to find another physician. I have no health insurance.
Here are my questions: Do I have to sign this contract w/him If I refuse, can he terminate? Do I have a right to wait until Im more stable emotionally? I have always paid, even for missed visits - what rights do I have?
Submitted: 8 years ago.
Category: Mental Health
Expert:  FamilyPhysician replied 8 years ago.
From a medicolegal perspective, a physician may terminate the doctor patient relationship for a number of reasons including non-compliance (failure to keep follow up appointments or take medication as prescribed).

To avoid claims of abandonment,physicians are required to provide some notice (typically 30 days), during which the doctor would be required to provide treatment of any emergency until the patient was able to transfer their records to another physician.

Other reasons to fire a patient would include failure to pay bills or aggressive, violent or threatening behavior.
Customer: replied 8 years ago.

I understand what you've written, but remain unsure to the answer of my question. Can my physician terminate his services, based on the information Ive provided?

 

"To avoid claims of abandonment,physicians are required to provide some notice (typically 30 days), during which the doctor would be required to provide treatment of any emergency until the patient was able to transfer their records to another physician."

--Does this mean if I can't find another physician he will have to continue treating me?

 

Other reasons to fire a patient would include failure to pay bills or aggressive, violent or threatening behavior. -- Does this mean if these conditions haven't existed, that he cannot fire me?

 

Thanks for any clarification.

Expert:  FamilyPhysician replied 8 years ago.
YES - the doctor can fire you based on the fact that you have missed multiple appointments (even if you have paid for them).

NO - the doctor does not need to continue treating you indefinitely until you choose another doctor. They only have to give you a "reasonable" amount of time to find another doctor. That new doctor need not be one that accepts your insurance or one that is even convenient to your location - just someone who could provide the services. Also, you could obtain services through a county mental health facility or emergency room. Unless there are factors that are beyond those normally encountered 30 days is generally considered the "standard" by most professional organizations.

You must understand that the physician is legally allowed (and to some extent almost obligated) to terminate the relationship to protect themselves in cases where the patient continues to miss appointments. If he continued as your physician despite your failure to keep appointments (for whatever reason), the physician exposes himself to risk that you would sue them for any treatment failure (even if the cause of that failure was you not keeping appointments).

If you want to stay with this doctor - you can sign the agreement (after reading it of course) and DO NOT MISS ANY MORE APPOINTMENTS. If not, your only option is to find another doctor.

If you were to take the doctor to court - they would of course immediately terminate you since the doctor-patient relationship at that point would be beyond repair. I don't know of a single doctor who would consider seeing a patient who was filing a lawsuit against them. In such a suit you MIGHT be able to collect money damages (if you could prove that the actions of the doctor were a violoation of the standard of care and were responsible for some harm to you), however the courts would NOT require the doctor to continue to treat you based on the history that you describe.
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