Work Stuff

Non-Compliance Ticks Your Doctor Off

I have a few patients that call me every five or six months trying to get an appointment with one of my doctors. I’ve come to recognize their names but somehow, or at least they act like, they don’t recognize me.

Nice try.

These patients have been black balled. Yes. It happens in health care, too.

Here’s why: The doctors have spent a GOOD PORTION of their clinic day, (and documented this time spent), trying to help the patients mentioned above. They go over (and over) test results and explain (over and over) what they see and what they recommend. Most times, the patients are not surgical candidates but because my (and I call them “mine” because I’ve grown fond of all of the doctors and it’s my job to try and make their jobs just a little easier so I’m protective of that responsibility), are nice doctors, they offer suggestions on what the patient can do to try and help themselves. They don’t immediately jump on the surgery bandwagon, even though that’s what they love to do and get paid well to do, and they WILL NOT prescribe any sort of pain medications unless they performed surgery on the patient.

Fair enough, right?

They will often recommended diet changes, exercise and sometimes injections – and sometimes, these things help, if the patients will take that advice to heart and make an honest effort toward feeling better.

But that’s not good enough for a small percentage of people. They want a quick fix – they want a pill or they want surgery so that the pain will go away. And to be fair, I get that. Sometimes you have so much pain that you just can’t get away from it. It’s utterly miserable and it affects the way you live your life. But that’s the point – it’s time to change the way you live your life. Often times, people have made bad choices and they now have to live with those bad choices. It’s time to step up and make better choices.

I’m in a unique situation because I truly see both sides of the story. And I empathize with those people who are truly hurting and for whatever reason, our doctors don’t recommend surgery so that leaves the patient … where exactly? Having to learn to live with it. People who receive this type of news break down at my desk and I feel so bad for them – I can see they are in pain, frustrated and not sure what to do next. We often refer these patients to a rehabilitation doctor who might offer them non-surgical pain management options, or to a pain clinic to help manage their pain. It’s heart breaking and I feel so helpless because I can’t help offer them anything but that referral.

But once in a while, and to be fair, it doesn’t happen very often, in fact, I can only think of four patients off the top of my head, who won’t take no for an answer. Not only do they not take no for an answer, they won’t even try what the doctor recommended. To be fair, if patients have tried the recommendations and another doctor has taken more films and thinks the patient needs to come back and see my surgeons, my doctors will see that patient, again, and re-assess their situation, again. (Eight times out of ten, a patient who has been sent back to our office by another doctor gets the same news – no surgery recommended).

But the patients who haven’t even tried the recommendations and want to get back in, nay, DEMAND to be seen, burn their bridge. Doctors are human and their time is valuable. They will bend over backwards to help patients (and I’ve seen all of them do that several times), they are human – they get tired of beating their heads against a brick wall and they will black-ball patients.

These are the patients who have been hateful, demeaning, insulting and downright nasty to either the doctor himself (it happens and it always amazes me that people even take that attitude with another human being, let alone someone they want to help them), or they are extremely rude, hateful, nasty to the staff.

(So yes, be nice to the staff. Because like I’m protective of my doctors, a lot of doctors grow fond of their staff – it goes both ways.)

Black balling means they put a pop-up on the patients chart to either check with the nurse first before scheduling (the nurse will call the patient and gauge the situation), or to simply not schedule them at all.

End of discussion.

Sometimes, if a patient has been black balled, another doctor in the same clinic will see the patient. Another doctor will look at the patient’s clinical information and if he feels like he can help that patient, he will agree to see that patient. Again, it’s not as cold blooded as I make it out to be. But if another doctor sees that the patient was non-compliant and refuses to heed advice or to even be civil – all bets are off. The patient will not be seen and will be forced to seek treatment with another specialist with another hospital.

So be careful, my friends. Doctors CAN and DO refuse to see patients if they are rude, nasty or simply refuse to meet the doctor halfway when it comes to his/her treatment.

And now with this disaster called Obamacare, I predict this will be even more common – not on a patient’s attitude or non-compliance, but because the patient’s insurance prevents the doctor from getting paid for his time and talents.

It happens. It’s happening now. Be nice to your doctor. Hell, be nice to everyone. Your attitude DOES matter in the grand scheme of things.