Anybody get fired by their neuro?

[tejokid]

Wow--the last thing I was expecting was a letter giving me 30 days to find a new neuro. Of course the only other neuros are an hour's drive away... I hadn't (honestly) given any reason to be dismissed--it seemed to come out of the blue, and the letter she sent really made no sense at all.

I suspect the real issue (not stated in her letter) was the paperwork involved with some of my prescriptions--all the prior approvals and hoops to jump through. The irony is that the problem medications are all ones she put me on to begin with.

Rejection stinks--I never even considered the possibility that a doctor would break up with me My initial reaction was shock and anger, but even though it's going to be a real pain to drive far enough to get to another neuro, something tells me this is saving me from something--a medical mistake, a bad situation--I dunno, it's kind of an odd feeling.

Has anyone else been dumped by the doc? It's frustrating!

[MSSINCE09]

ridiculous

If her sole reason for discharging you from her practice was because she is to lazy to do paperwork what else is she to lazy to do? I think you are right I am a firm believer in karma and that this was done to save you from her lazyness. When I worked in the medical field as an office supervisor it was my job to write the discharge letters for the docs and have them sign after approval. Our #1 reason for discharge was drug seeking. #2 not following through with appropriate testing. Never because of too much papework. Thats all we did was paperwork. I hope you have good luck with your new neuro.

[gomer]

I had THREE neuros dump me while trying to get the needed testing for MS, 2 were because I was too old for their drug trials, another said he would not treat me for MS even if he did the testing. A far different situation than yours.

I did have an eye doc rather rudely semi-dump me in 2007. I had been with him for well over 12, maybe 15 years. His reasoning was I was not under the care of THE diabetes endo he wanted me under. It was a catch-22, this endo ONLY takes patients on referral, yet this same doc REFUSED to give me the NEEDED referral... go figure? He was not happy with my diabetes control was one issue he was mad about. I was also in serous need for cataract surgery as well. another eye doc, nice guy but otherwise wrthless, then a GREAT eye doc later that same year was fantastic who did my cataracts.

I would have loved to stay with this eye doc but he was a specialist and so I still needed a new general eye doc. Another eye doc in the same practice was worthless, so off to yet another new eye doc. I NEEDED my prisms updated but he would not do that, but he opened the MS can of worms and the seeking a formal Dx of the MS began. Needless to say I am still with him for general eye care.
For me it was, in a round about way, a good thing, in the end.

Who, in their right mind, would want an unwilling doc treating them, let alone have much if any TRUST in that doc?

You may need to shop around a bit, can be a hassle, but in the end it might be worth it.

Gomer Sez, good luck, & hope you can find better.

[0485c10]

I wasn't ever fired by my neuro, but i was told i should find another doctor if i didn't follow his advice on an MS DMD.
any crab drug approved to treat MS versus ldn. he said he did not want to see me as a patient if i chose to go with ldn.

everyone is so quick to say get a new doc for any controversy people have with their doc...but it goes both ways a doc can chose not to see the patient as long as its not an immediatly life threatening situation.

that's not your case. I'm sorry you are having to deal with the situation your going through, its stressful.

i did have a neuro send me a letter that she would no longer be in practice as she had family committments. a anothe neuro at the clinic assumed my care. then a year later she began practicing at a different clinic, i called and asked if she was taking new patients. her nurse said yes she was, so i switched to her and haven't regretted that decision.

she is young, so i suppose if she decides to have another child i will get another letter not explaining anything just that she will no longer be in practice.

[Redwings]

I suspect the real issue (not stated in her letter) was the paperwork involved with some of my prescriptions--all the prior approvals and hoops to jump through. The irony is that the problem medications are all ones she put me on to begin with.

Hi tejokid:
That is frustrating! If the real reason you're being dismissed is paperwork, that stinks, but I doubt it's because your doctor is "lazy."

Medicine is a business, and time is money. It isn't your fault -- but it isn't your doctor's fault either -- if your insurance doesn't pay well enough to cover her time or her staff's time to keep pushing paperwork. Inadequate pay means she and her staff are essentially working for free to do paperwork. It's shortsighted to accuse someone who doesn't want to work for free of being "lazy." How long would you work for free? How would you feel about being called lazy because you couldn't afford to work for free? There's an economic reason why there aren't more neurologists in your town.

I've never been fired by a doctor, but I've had a couple leave their practices, and I had to find new doctors. I've also had several doctors decline to take my case (including one who agreed, then changed her mind later) because it was too complicated for them. (On the other hand, I've also had to leave several doctors for the same reason.) Frustrating, repeatedly, to be sure, but ultimately all for the better.

Whatever the "real" reason is for your neuro dismissing you, there's nothing to be gained by taking it personally. I think you've reached the right conclusion: it's in your best interest to move on. I hope you have a long and satisfying partnership with your new neuro.

[kingrex]

Wow--the last thing I was expecting was a letter giving me 30 days to find a new neuro. Of course the only other neuros are an hour's drive away... I hadn't (honestly) given any reason to be dismissed--it seemed to come out of the blue, and the letter she sent really made no sense at all.

I suspect the real issue (not stated in her letter) was the paperwork involved with some of my prescriptions--all the prior approvals and hoops to jump through. The irony is that the problem medications are all ones she put me on to begin with.

Rejection stinks--I never even considered the possibility that a doctor would break up with me My initial reaction was shock and anger, but even though it's going to be a real pain to drive far enough to get to another neuro, something tells me this is saving me from something--a medical mistake, a bad situation--I dunno, it's kind of an odd feeling.

Has anyone else been dumped by the doc? It's frustrating!

Doctors don't simply drop patients for no reason, and I'm not sure from what you wrote that there was no explanation given, unless there was an incident or incidents which led up to the action. I don't mean that you were rude or abusive; there are other conditions which might warrant this action, but right or wrong, misunderstanding or not, there has to be a reason. Cancelling or no-showing for appointments multiple times could do it, for example.

Regarding paperwork - doctors themselves do very little of it, so I wouldn't think that this has anything to do with it. And FWIW, patients are a doctor's source of income, and most overbook (I got in to see my orthopedist at 7:30 PM tonight, two hours past my appt. time, because he overbooks - they all do). Dismissing patients costs them money, under normal circumstances.

So...might there be more to the story??? Inquiring minds wanna know.


rex

[Redwings]

Rex has hit on the uncomfortable truth -- doctors don't drop patients for no reason. Saying that you suspect the "real issue" (not stated in your doctor's letter) was the paperwork involved implies that there was a reason stated in the letter that you didn't share in your post. There must be a documented reason, if for no other reason than to show that the dismissal wasn't discriminatory or otherwise illegal. So misunderstanding or not, the reason could be simply the one given in the letter.

I do have to disagree on one point. It's true that patients are a doctor's source of income. However, there's also a cost for providing care, and sometimes the income barely covers the cost of doing business. An office's gross income might be high, but the net income low because the cost of doing business cuts into profits. The costs of having to hire extra staff to process claims and paperwork can significantly chew into net income.

For example, Medicaid payments don't cover the cost of doing business, which is why so few doctors accept Medicaid. More doctors are dropping out of Medicare because of insufficient payments. But doctors also drop private plans for the same reason. I've worked in medical billing and accounts receivable and seen several doctors drop bad insurance plans, and thus, patients because they were only breaking even on them or even losing money.

Just because your neuro is the only one in town doesn't mean she's sitting pretty financially. If there were that much money to be made in your town, odds are there would be at least one other neuro competing for it.

Poor insurance payments are increasingly becoming a reason why patients are dismissed from practices. Usually it transpires by the doctor dropping the plan, but there can be other factors involved. And bad insurance is one of the reasons behind dismissals for seemingly vague causes.

I've witnessed doctors dismissing patients. Dismissing patients costs money, but often it's a smaller loss than if they continued to see them. Dismissing a patient usually costs no more than the price of a registered letter and copying/mailing a chart to the next doctor. Even if it costs more than that monetarily, the patient is being dismissed because the cost (financial and otherwise) of keeping them exceeds the rewards of keeping them.

If you otherwise liked this doctor, you can try to repair the relationship. It might be worthwhile trying to because there's no other neuro close by. But generally, once the relationship has broken down to the point that the doctor has dismissed the patient, there's no going back to what it was.

Be sure to get a copy of your records. The office might not charge you for them because they initiated the dismissal. If there aren't any clues in your records about the "real reason" for your dismissal, you could try looking over the copy sent to your new neurologist.

I'm sorry this happened to you. Regardless of what the untold part of the story is, I'm still of the opinion that it's best for you to let this one go and move on to a new doc.

[Jefferson]

Firing a neurosurgen

I fired a neurosurgen for call me a lier, when told me I had a very colorful history. He also said that the neurosugen that removed a tumor from C5 - C6 paralyzed me from the neck down, that was not true the hospital would not let him do emergency surgery in 1958 because it was exploritory surgery. So because of that I was paralyzed for the neck down and having beathing problems, the next day after that I had emergency surgery. That doctor saved my life and that is almost 54 years ago.

That neurosurgen has black balled me with every neurosergen and neurologist in Spokane, Washington.

So I will have to traval out of Spokane or maybe out of state to get a good neurological evaluation.

Count yourself lucky that that neurologist has black balled you.

My best wishes,
Jefferson

[tejokid]

Thanks everybody for your responses. This particular situation just seems odd in so many ways. I didn't reveal the details of the doctor's letter in order to protect her identity--she was, after all, a good and caring doc for 6 years. There's a lot I don't know--I'm not sure that she's not ill herself.

Her letter mentioned two items--one was that an Rx was delayed because it wasn't on my insurance's formulary so it had to be approved. However, the letter from the mail order prescription company said they couldn't fill the first prescription they received because the doc hadn't signed it and hadn't responded when they asked her to correct it. (For whatever reason, she was out of the office for several days.)

The second item was--well, really peculiar. There has never been a grab bar in the bathroom in her office, and the last time I was there I noticed that there was a board and big bolts on the wall to hold the toilet paper holder on the wall. Since I'm one of those DIY people, I made a lighthearted (I thought) suggestion to her receptionist that people were using the the toilet paper holder to hoist themselves off the seat.

I never needed help getting off the commode there--nothing like that ever came up, it was just an observation. Her response in the letter was that they were aware of the problem and couldn't fix it because the landlord wouldn't make the needed changes for a grab bar. Then, "In the interest of your health and safety, you would be better served by an office that can handle your needs." Uh--what?

She stated that anyone who needed help in the bathroom would be helped by the nurse. Doesn'te the ADA require landlords to equip medical offices properly or something? Is a nurse's assistance an adequate substitute for a built-in grab bar? I'm just addlepated--I feel like I was fired for suggesting something that every other medical office has, and ought to have.

Redwings--I'd be interested in your input--I'm not familair with how such things work. My thanks to you all for your comments--I feel sort of untethered here until I get in to see my PCP to ask about a referral. It's nice to have a little sympathy, ha.

[Redwings]

Peg, that is strange, strange enough that it's hard to tell just what your doctor was thinking in deciding to dismiss you. I get the impression there's a backstory to the bathroom accessibility issue that's made your neuro's office so sensitive about any suggestion of it that they'd rather dismiss you "in the interest of your health and safety" than deal with another possible problem.

You may never know how your lighthearted comment was interpreted by the receptionist or how it was relayed to your neuro. Since your neuro didn't hear your comment directly from you, it may have been garbled in the transmission. (When your comment got to your neuro, it was hearsay.) That might be enough reason for you to communicate directly with your neuro to try to clear up a misunderstanding, either by phone or by letter. A letter might be preferable because it becomes part of the legal record, and you certainly deserve to have your side heard and on record.

You said your neuro was a good and caring doctor before. Do you want to continue being her patient after she dismissed you for a vague and unfounded reason?

How legal her basis for dismissal is depends on the laws in your state. All things considered, is it something you'd like to pursue legally? As far as the ADA goes, there are exceptions to handicap-accessibility rules, and there are no federal laws that require doctors' offices to be only in handicap-accessible buildings. Your neuro can't force her landlord to provide things that aren't required by law. It sounds like she might have been caught up in this issue before and she's dealing with the unpleasantness by dismissing patients who might bring it all up again.

The whole situation is unfortunate, and I'm sorry it happened to you. I wish there were something I could offer that could help get you out of it without any more grief, but there isn't.

[seena]

Well my last appt. the neuro introduced me to a NP and said she will be meeting with me from now on. Kind felt like being let go.

I know he has to sign off on her paperwork. But no I haven't been let go to find my own neuro.

[jbuckz]

I did not really get fired but my neuro finally put her hands in the air and referred me to the Cleveland Clinic in Las Vegas and it was really the best thing that could have happened to me. I have been having a horrible fair up that has been lasting for about 4 months now and they have gotten it under control.

At least my old neuro referred me somewhere, I have never been kicked to the curb in the past.

I would agree with everyone else that it had to have been a cost issue as I have had doctors in the past stop taking my insurance due to cost reasons.

[tejokid]

Redwings, you're absolutely right--I do not want to continue being her patient. My initial reaction was what we all feel with rejection--shock, anger, hurt--but as time goes by, I'm mostly worried about the doctor. I have respected her (still do)--I'm just astonished at what has happened. (And annoyed that it requires me to travel such a distance to see someone else, when travel isn't so easy anymore.)

No way would I consider legal action on the ADA issue or anything else. We're such a litigious society, suing everybody like it's a winning lottery ticket to make us rich, but then we wonder why medical costs are so high--people create the situation and then complain about paying for it. (I could get on a rant about the whole medical system, but I'll spare everybody the drama, ha.)But mainly I don't think she deserves it--it's a wack-a-doodle situation, but whatever her reasons, I think it was self-protective in some way, not malicious.

[0485c10]

I know he has to sign off on her paperwork. But no I haven't been let go to find my own neuro.

I don't think the physician has to sign off on her paperwork, i think the physician only has to sign off on paperwork of a PA=physician assistant.

I went through this issue, of MD,NP,PA at a time that the DMV did not want to renew my drivers license...so i needed to get a few "legal" signatures and i found that a PA, had to have everything also signed by the supervising MD...but an NP signature is as good as an MD's. I think this distinction has been fined tuned because of the projected upcoming health care provider shortage--especially in states where the shortage will be acute, the NP can hang a shingle without a supervising physician.

or that might be a state defined thing and that's just how its defined in the state i live in.

[freeinhou]

Yeah, I've been fired. I've been to a couple neurologists that didn't want to see me because I don't take a dmd.

Tom