Magazine article Medical Economics

Are Relations with Patients Getting Worse?

Magazine article Medical Economics

Are Relations with Patients Getting Worse?

Article excerpt

Ironically, just as managed care has made it harder to break the doctor-patient relationship, doctors may have more reasons for doing so.

One cause is the see-you-in-court syndrome. "In the past, if a doctor and patient didn't hit it off, there was a more casual attitude," says Stephen R. Smith, administrator of the Fort Wayne Neurological Center in Fort Wayne, Ind. "You hoped for the best--maybe things would improve. But now, because of the possibility of litigation, there's a more aggressive risk-management strategy that says, 'Don't do business with someone you don't get along with.' As a result, dropping patients is more commonplace."

With the threat of court action in the air, even missed appointments are prompting physicians to tell patients goodbye. Medical management consultant Stevan D. Olian in Burlingame, Calif., recalls the case of an ophthalmologist treating a lackadaisical patient who had a serious eye disease.

"The patient skipped his appointments over a three-month span, and in the meantime his condition progressed so rapidly that he went blind in one eye," says Olian. "He sued the doctor for a six-figure sum and received a small settlement to shut him up. When you see patients like this, you want to get rid of them in a hurry."

Some observers say the problem goes beyond lawsuits; patients tend to be more antagonistic, period.

"My instincts tell me abusive behavior by patients is more prevalent now than it was 20 years ago," says Thomas E. Kirchmeier, vice president of risk management at Physicians Insurance Exchange, a malpractice insurer in Seattle. …

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