Getting Fired by Your Physician

Occasionally people complain they have been denied medical care, even reporting that they had appointments canceled after waiting to see a doctor. They believe they have been blacklisted or blackballed in some way, through a network of providers who share information about difficult, difficult to diagnose, or difficult to treat people.

When a person creates problems for her medical providers – whether she behaves poorly in the office, refuses to pay for services rendered, files frivolous lawsuits, or doesn't comply with treatment but blames the doctor when her health doesn't improve – the doctor may decide she just doesn't want to treat that patient any longer.

A provider group could "ban" a patient, but most compete for the same limited pool of patients, so there's no economic incentive to share such negative information. That said, there are anecdotal stories of physicians who say they maintain lists of patients they will not work with – and patients who say they cannot get appointments, or that they are routinely canceled by office staff, because of what they believe is "blacklisting."

Providers can "discharge" a patient from their practice. Usually, if you have a poor relationship with your doctor, you'll find a different doctor. However, some physicians exercise their legal right to withhold non-emergency treatment for patients who decline to meet their basic standards of conduct.

In general, a physician will discharge you from his or her medical practice if you've demonstrated disrespectful behavior, refuse to follow medical advice, or refuse to pay your bills. This practice is generally considered a last resort. You'll receive a letter telling you that you've been discharged. This letter won't bar you from finding another doctor, although you might not find a doctor in the same medical practice.

Sometimes a doctor will refuse to see you because the practice does not accept the kind of medical insurance you have. For example, a primary-care physician might only allow a certain percentage of her practice to include Medicaid patients because Medicaid doesn't reimburse at the same rates as Medicare and commercial insurance. So the practice manager might refuse to admit you into the medical practice. This behavior is legal and does not constitute a blacklist because you're free to seek services with a physician who does accept your form of insurance coverage.

Savvy people know that no one wants to deal with difficult people. Granted, there are many reasons people become frustrated or angry about the treatment they do – or don't – receive. Some patients feel they "deserve" to be disruptive or difficult as if defiance is the only way they will get the help they need. Usually, however, that disruption generates an adversarial approach to the doctor-patient relationship.

Arming ourselves with creative and positive tools will go much further toward getting ourselves the help we need. We can't demand respect and expect to get it. We must command respect. Know the difference and approach your providers accordingly.