Your Facade

Chicago 023

Today I had to tell a patient that they needed to seek care elsewhere in the future.

I hate, hate, hate dismissing patients from my practice but in this case, it had to be done. They had been consistently verbally abusive to my staff and made unrealistic demands that infringed on the rights and care of other patients.

I understand that when someone is ill and hurting and scared that their behavior is likely not representative of who they are in reality. Generally bark is much bigger than bite for most people, once you are able to get past their facade. So I make a lot of allowances.

It takes a lot to get yourself fired from my clinic. Really.

I have to act like I don’t care. I let all of the bravado bounce off of me. I am firm and unrelenting, the big boss woman standing up for everyone.

Still…. It makes me feel like a failure somehow.


24 thoughts on “Your Facade

  1. It is hard to do but I have always felt more relieved once it is done. I just think that sometimes boundaries need to be drawn and we cannot help people who blames everyone else for their troubles. I am sure it is for the best and it is a very good thing that you stood up for your staff.


  2. Having to tell a patient to seek help elsewhere is possibly the hardest thing to do…. That said, you are right saying everyone deserves the same level of respect they demand out of proportion.
    All anyone can do us their best…. I prescribe a glass (or two) of vino and plenty of hugs ! ( 🙂 )
    Blessings, Susan x


  3. Here’s another point of view — your patients can fire you without any comment or even telling you why. You have the same right to “fire” them. I used to go to a general practitioner who was notorious for telling you to see someone else if you didn’t follow his directions. He had overweight ladies in his practice that wanted diet pills but didn’t want to cut back on eating. He also had diabetics that didn’t follow through. He had no patience for people who wouldn’t work with him to get healthy. I liked him because he was so “no nonsense.” I had undiagnosed (by several docs) chronic appendicitis for many years. I was with him for two months and I was on the operating table and all was well.


    • Great point! I have told people that if they don’t shape up they need to go ahead and sign their DNR (do not resuscitate) papers now because it was not fair to ask for heroic measures when you won’t do a few simple things to ensure you don’t get there in the first place. But when I cannot get someone to see the light and take charge of their health, I DO still feel like a failure. I think people will see more of the firing for not controlling diabetes and weight and such as time goes on because those measures are being followed by insurance companies (my patients’ scores affect my reimbursement) and by quality watchdog groups (like CMS, the governmental Medicare oversight group) that publish data. But my philosophy is that these people DO have to get care somewhere. Even some control is better than no control in order to prevent them from becoming a burden on the system. Does my patients having a good BMI mean that I am good at getting them to loose weight or does it mean I fire everyone over a BMI of 25? This might actually make a good post! Hmmmmm.


  4. Maybe you could view it as…you actually helped them…? For sure, it will make some kind of mark…they will have to “think” about it. Maybe this person will have a huge breakthrough because you were so kind to let them go!! 😉


  5. I interact with numerous doctor offices because of my job. I think the staff/doctors put up with an incredible amount of stress and even abuse. You can only take so much. I am sure your staff is appreciative of your actions and still know how difficult it is for you.


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