Years ago, I was forced to make a huge life-changing decision by relocating to a new city in order to be closer to family. When I realized I would be moving to a different county within Southern California and would have to change jobs, I knew it would be inevitable that I would have to say goodbye to my patients. I was dreading this. I mean, really dreading it. I don’t like goodbyes. I felt as though we were breaking up ... and in a way we were. Like any other relationship, my patient-physician relationships are very important to me. But sadly, they were swiftly coming to an end. I know that as a doctor, I am supposed to refrain from getting attached to my patients. But how is it possible to retain this distance? I am human, after all—all doctors are. I had been taking care of my patients for years. I had seen them routinely, perhaps more frequently than some of my own family members. I cared for them, their kids, their spouses, and their grandparents. I have gotten to know what their hobbies are, what they are afraid of, and perhaps their deepest, darkest secrets. I have laughed with them. And yes, I have even, on occasion, cried with them. And because of this intimacy, it can be impossible not to grow attached, which makes leaving even more difficult. I remember when I broke the news to one of my patients. She started to sob. I mean really sob, with a fountain of tears. I didn’t know what to say or what to do, except to hug her and tell her I was so sorry. I felt as though I was abandoning her. It was difficult. I reassured her that she would surely find another physician that she would connect well with. In the end, I didn’t regret telling her. I knew that she needed to know, no matter how difficult it was to relay the news. I have heard of physicians leaving without saying goodbye to their patients, and I do understand why—probably because it’s not easy to say goodbye, whether we admit it or not. It’s awkward, unsettling, and emotional. Physicians aren’t supposed to get emotional. It would certainly be much easier to sneak away without having to face emotions—both mine and my patients. But no matter how difficult, I had to say my farewells. It was the right thing to do for many reasons: Insurance Lead: Many insurance programs require you to select a primary care doctor (PCP). If I don’t tell patients that I am leaving, they will fall behind in this process and may even be randomly assigned to a new doctor. In saying goodbye, I can give them the heads-up so that they can start looking for a new PCP, instead of being randomly assigned to a physician that they may not connect well with. Sign-Out: I know them well, I know their health issues, and I know their personality. In this way, I also know who they may “match-up” well with. I can give them a few names of physicians that I think they would connect with, so that they are not left in the dark. I care about my patients and I want them to be well taken care of after I leave. Closure: Some of my patients may feel as though I have “abandoned” them after I leave if I don’t give them a heads-up. I would feel very uncomfortable if they were to feel this way. They need closure, and so do I. Like any other relationship, I have to tell them so that we can both move on in a healthy, mature manner. Pre-Preparation: When they meet their new doctor for the first time, they need to be prepared. They need to bring all their medication bottles, a list of their health problems, and mentally, they need to be ready to re-establish from scratch in case their new doctor has questions. If I don’t say goodbye, I will have robbed them of this pre-preparation period. They need to be ready. Ethics: Like any other relationship, my patients deserve an exchange of communication from the two sides. Physicians are professionals, and providing this closure for our patients is the ethical way to handle it. And it’s just the right thing to do. Like any other relationship, the physician-patient relationship is also one that forms a connection and bond, depends heavily on a two-way communication system, and may involve various ups and downs throughout time. As much as we try not to show it, we doctors have emotions, too. And breaking up for us … is also hard to do. Source
