Doctors complain about patients, too As frustrated as patients often are by doctors who have lousy bedside manners, are short with us, arrogant, or sometimes just won't spend enough time with us, there are plenty of doctors who complain about patient behavior, too. That may lead doctors to reject some patients, which in turn denies them the medical care they need. Problem Patients Problem patient behavior ranges from being disruptive in waiting or exam rooms, to not paying the doctor's bills, to filing lawsuits. Patient behavior is probably aligned on a bell curve like so many aspects of life: some patients are so passive they are barely remembered at all, most patient behavior is collaborative and respectful, and some patients, at the extreme, are aggressive, disruptive, and extraordinarily difficult. Nobody wants to deal with someone else who behaves in those ways. It's no surprise doctors don't either. If a patient is mildly unpleasant, a doctor may spend time with her, but accomplish the meeting in as short a time as possible, or refer her to someone else as quickly as possible. Some patients complain they cannot find any doctor to care for them at all, even reporting that they had appointments canceled after waiting to see a doctor. Other patients have complained about being "fired" by a doctor, being told the doctor no longer wishes to work with them. A report in the New York Times corroborates this phenomenon. Rumors of secret codes posted to a patient's chart by providers, signifying that the patient is difficult, turn out to be true. There may be a notation in the patient's record that is as simple as PITA (pain in the "backside") or "GOMER" ("get out of my emergency room".) One former healthcare worker reported that her office used a real ICD code in patients' records: 569.42, indicating anal or rectal pain. Others reported additional codes that would indicate the patient was a problem. Still, other patients believe doctors or other providers are sabotaging their records so no other doctor will even see them. They report being blackballed or blacklisted, believing they cannot get an appointment with any doctor, anywhere, and believe the only way doctors who are out-of-state or even out of their country could know to reject them would be if such a blacklist existed. How Can Doctors Refuse to Treat a Patient? Many people believe that a doctor could not possibly get away with not treating a patient. They cite patients rights, or a doctor's oath of "first, do no harm." In fact, neither of those is a reason a doctor must accept a patient into her practice. In the United States, the only time a patient has a right to care is when that patient needs true emergency care and accesses the emergency room of a hospital that accepts federal money through Medicare (see EMTALA.) Even then, if a patient is deemed not to require emergency care, he may be refused care and told to see his primary care physician or to check in with an urgent care clinic. Source
