Things got heated today in The New York Times Health section with today's Cases article. Dr. Rahul Parikh discussed a case in which he decided to fire a patient from his practice. Well actually, his problem wasn't with the 14-year-old patient but the patient's mother. The case set off a prolonged discussion about physician responsabilities, patient responsabilities, and who and how and when a physician-patient relationship can and perhaps should be terminated.
Everyone can agree that a physician shouldn't put a patient's health at risk in terminating a relationship, and sufficient time should be allowed to find another physician. But what is a good reason to terminate a relationship? Is non-compliance a good reason? Is personality a good reason? Does the doctor have an obligation to probe deeper into why a patient is non-compliant? Or can a doctor just cut loose an annoying patient?
As with any relationship, the patient-physician patient is built on trust. If the doctor cannot trust the patient, is there any good reason to keep the relationship going? Could keeping a poor relationship going potentially put the patient at greater risk of harm?
You can find the case and discussion here: http://www.nytimes.com/2008/06/10/health/views/10case.html?ex=1370836800&en=3343f835511192ce&ei=5124&partner=permalink&exprod=permalink.
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