My sleep doc fired me today...LOL

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old64mb
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Re: My sleep doc fired me today...LOL

Post by old64mb » Fri Jan 29, 2010 9:24 pm

JeffH wrote:He told me his office would no longer be seeing me as a patient.
Depending on how angry you are at this guy, you may have grounds to sit down with an attorney.

There are a lot of ifs in that though, including if you'd be willing to front the money to do so. I'm not sure if referring you back to your PCP with a psychiatric recommendation is technically considered abandonment - I suspect it'd hinge on if your PCP has experience in sleep medicine and would be willing to go to bat for you against this guy if it came to that - but all this is something best discussed with someone who has passed a bar exam.

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Re: My sleep doc fired me today...LOL

Post by ScrappinMom » Fri Jan 29, 2010 9:38 pm

old64mb wrote:
JeffH wrote:He told me his office would no longer be seeing me as a patient.
Depending on how angry you are at this guy, you may have grounds to sit down with an attorney.

There are a lot of ifs in that though, including if you'd be willing to front the money to do so. I'm not sure if referring you back to your PCP with a psychiatric recommendation is technically considered abandonment - I suspect it'd hinge on if your PCP has experience in sleep medicine and would be willing to go to bat for you against this guy if it came to that - but all this is something best discussed with someone who has passed a bar exam.
No, it's not abandonment. He referred JeffH back to his PCP. However, I think there is enough to file a complaint with the state licensure board. He was very unprofessional.

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JeffH
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Re: My sleep doc fired me today...LOL

Post by JeffH » Sat Jan 30, 2010 8:29 am

ScrappinMom wrote:
old64mb wrote:
JeffH wrote:He told me his office would no longer be seeing me as a patient.
Depending on how angry you are at this guy, you may have grounds to sit down with an attorney.

There are a lot of ifs in that though, including if you'd be willing to front the money to do so. I'm not sure if referring you back to your PCP with a psychiatric recommendation is technically considered abandonment - I suspect it'd hinge on if your PCP has experience in sleep medicine and would be willing to go to bat for you against this guy if it came to that - but all this is something best discussed with someone who has passed a bar exam.
No, it's not abandonment. He referred JeffH back to his PCP. However, I think there is enough to file a complaint with the state licensure board. He was very unprofessional.
BTW, ScrappinMom, this is the same Doc that you used....

JeffH

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Re: My sleep doc fired me today...LOL

Post by elg5cats » Sat Jan 30, 2010 8:49 am

When a health care provider "fires a patient" the health care provider has an obligation to link the fired patient to an "equally" qualified provider. This is often done by identifying a provider who has agreed to see the fired patient, sending a certified letter to the fired patient identifying the provider willing to offer services to the fired patient. If interruptions in care occur causing negative consequences, that's a serious infraction for patient abandonment and the firing provider can be at risk professionally and with liability. Firing a patient who needs medicine for a benign rash and firing a patient who needs insulin, 02 etc may carry different implications for the health care provider. A specialist firing a patient with a referral back to a GP is engaging in patient abandonment if the patient continues to need the specialist level of care at the time of firing.................Isn't professional grade temper tantrums an interesting phenomena. And arrogant!!!!

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Re: My sleep doc fired me today...LOL

Post by ozij » Sat Jan 30, 2010 9:31 am

A reminder of what this is about:
viewtopic.php?f=1&t=48665&st=0&sk=t&sd=a#p444455
In this case, the patient refused the doctor's care by disagreeing with his Rx, and insisted on something else. My emphasis.
So I got 4.5 hours sleep at the sleep study and that was after taking sleeping pills twice...I'm a sick unit. Woke up 4 times in the night with the third one having my belly on fire. The tech came in and I asked her what pressure she had me at. She said 15. I said I'd heard of the air in the belly deal but never experienced it....I have now! She turned it back down to 13 and I got a little more sleep. When I woke up this morning I DID feel the old feeling of being more rested that I haven't felt in a long time.

Went to the Doc's at 9:00 and he said I needed to try a Resmed in APAP mode and if that didn't work, we'd go to a Bipap. He sent me to a DME and I left with a Resmed Escape II APAP. He just hates the algorithm of Respironics machines and said Resmed is a far superior machine.
<snip>
It's set up to start out at 13 and the upper end is wide open. I'm going to play around with the ERP or EPR or whatever the hell is called. He said to use it.
Jeff refused that course of therapy on the grounds that there' s no data reported on that machine, and insisted on another machine; he also implied the course of therapy was decided by financial considerations, and not his well being.


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Re: My sleep doc fired me today...LOL

Post by ScrappinMom » Sat Jan 30, 2010 11:24 am

I have absolutely no disagreement that the way JeffH was treated was completely WRONG! It's just my opinion that the OK Licensure Board will not see it as abandonment. But, that is really neither here nor there, it doesn't really matter what you call it, the dr was very unprofessional.

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Re: My sleep doc fired me today...LOL

Post by old64mb » Sat Jan 30, 2010 12:24 pm

ozij wrote:In this case, the patient refused the doctor's care by disagreeing with his Rx...
Among other reasons, this is why I suggested that if Jeff is angry enough, he sit down with someone who is familiar with medical malpractice and the quirks in his local law because none of us know enough details to make a judgment call here on whether or not he can go after the guy.

Typically, if you refuse an Rx or a recommended course of treatment, the MD will note that your actions were taken "Against Medical Advice (AMA)." Among other things, this tends to protect them from malpractice if you go ahead and die from your condition. Did Jeff's doctor consider this AMA, note it in his record, and note that he was referring him someplace else because of the AMA? Got me. Does that offset firing him improperly, which it sounds like he did but we don't know for sure? I doubt it, but again, I don't know.

This is where an attorney, years of practice, and subpoenas come in. My gut is that the doctor lost his cool and did something really dumb and impulsive here to show how powerful and smart he was without being concerned about the longer term consequences, but I honestly don't know enough about this area of the law to say one way or the other.

I do know attorneys are often more expensive than doctors, malpractice attorneys often tend to be scum of the earth ambulance chaser types, and Jeff's relationship with the rest of his medical practitioners and such might not be worth risking if they happen to be friends with this guy. But, again, if Jeff is angry enough and thinks it might be worth it, this is where a sitdown with an attorney would help, since again my gut is that there's probably enough here to if nothing else scare the heck out of the MD. The attorney could also advise Jeff on what my I'd bet would be the proper immediate course of action to take next if he wants to go down that road, which is to make a sustained effort to find another sleep doctor ASAP who has an appointment available in the next 30 days and maintain detailed notes about the search. If Jeff can't find one, then I'd suspect the previous sleep doctor may have really opened up a can of worms - but again, this is why you hire someone for advice rather than take it off of an internet forum.

If not, just write up an angry anonymous review on yelp or such (with no personally identifiable details about the case so he can't go turn around and have one of those internet monitoring agencies some MDs use go after him) and feel better that way. If it were me, I'd probably do the latter course of action only because I've found it's just not worth the effort most times to be as much of a jerk to someone else as they are to you.

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Re: My sleep doc fired me today...LOL

Post by elg5cats » Sat Jan 30, 2010 5:29 pm

ozij wrote:In this case, the patient refused the doctor's care by disagreeing with his Rx...
When a patient disagrees with a treatment plan, the refusal or disagreement doesn't permit patient abandonment. If the health care provider has diagnosed a condition, formed an opinion treatment is necessary, they cannot just bail out on the "uncooperative patient" w/o making a direct attempt to refer the patient to a different health care provider who treats the conditon. If the doctor/other health care provider does not wish to continue treatment for whatever reason, a reasonable effort to refer to a health care provider qualify to treat the condition identified is required to protect from allegations of patient abandonment.....patient doesn't have to accept or follow through, but health care professional needs to exit a professional relationship with patient without disrupting availability of care.
old64mbTypically, if you refuse an Rx or a recommended course of treatment, the MD will note that your actions were taken "Against Medical Advice (AMA)." Among other things, this tends to protect them from malpractice if you go ahead and die from your condition. Did Jeff's doctor consider this AMA, note it in his record, and note that he was referring him someplace else because of the AMA?
My gut is that the doctor lost his cool and did something really dumb and impulsive
It's well known within the medical profession, a good relationship or being liked will reduce liability even when serious medical errors have occurred. It's the dissatisfied unhappy angry customer who is most likely to seek legal consultation!

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