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June 27, 2012

The Non-Compliant Patient, Dismissing Should be a Last Resort


Not long ago, a pediatrician colleague and I were discussing the current recommendations for childhood immunizations. The conversation soon drifted toward the issue of parents who refuse to immunize their children against certain illnesses. This particular pediatrician, one of a six-member practice, said he and his partners had decided that children of parents who refused to have their children immunized would no longer be seen in their practice.

This issue of non-compliance is probably more prevalent than ever. More diagnostic and treatment options for more illnesses have made decision-making for doctors, as well as their patients, increasingly complex. Patient access to medical advice on the internet sometimes creates confusion and conflicting alternatives.

When a patient refuses a procedure or recommended treatment, is it ethical or appropriate
for a physician to drop the patient? It's my personal opinion that dismissing a patient should be a last resort. Every effort needs to be made to understand the patient's perspective and tactfully explain our own position.

If all else fails, and the decision is made to terminate the relationship, it's important to document that the patient has been informed of the possible consequences of failing to follow medical advice. To avoid being sued for abandonment, it's critically important to carefully follow our medical society's protocol for discharging a patient from our practice.

Every doctor has made a commitment to care for their patients as best as we know how. In the end, however, it's still the patient's decision whether or not to follow our advice.

Ken Teufel, M.D.
Ken Teufel is the Medical Director for Interim Physicians

 

 

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