Something to think about. IMO corporate medicine has a big hand in this.

When Claudia Siegel got a stomach bug earlier this year, she reached out to her primary care doctor to prescribe something to relieve her diarrhea. The Philadelphia resident was surprised when she received an online message informing her that because she hadn’t visited her doctor in more than three years, she was no longer a patient.

And since he wasn’t accepting new patients, she would have to find a new primary care physician.

“I think it’s unconscionable,” Siegel said, noting that many patients may have stayed away from the doctor’s office the past few years because of the covid pandemic. “There was no notification to patients that they’re on the verge of losing their doctor.”

Though it is dismaying to learn you’ve been dropped from a physician’s practice because a few years have passed since your last visit, the approach isn’t uncommon. Exactly how widespread the experience is, no one can say. But specialists also do this.

The argument for dropping the occasional patient makes some sense. Since many primary care doctors have a waiting list of prospective patients, removing those they rarely see opens up patient slots and improves access for others.

“Most primary care practices are incredibly busy, in part due to pent-up demand due to covid,” said Dr. Russell Phillips, director of Harvard Medical School’s Center for Primary Care and a general internist at Beth Israel Deaconess Medical Center.

“Even though continuity of care is important, if the patient hasn’t been in and we don’t know if they’re going to come in, it’s hard to leave space for them,” he said.

Patients often move away or find a different doctor when their insurance changes without notifying the practice, experts say. In addition, physicians may seek to classify people they haven’t seen in a long time as new patients since their medical, family, and social history may require a time-consuming update after a lengthy break. Patient status is one element that determines how much doctors get paid.

Still, the transition can be trying for patients.

“I can completely understand the patient’s perspective,” said Courtney Jones, a senior director of case management at the Patient Advocate Foundation. “You believe you have a medical team that you’ve trusted previously to help you make decisions, and now you have to find another trusted team.”

Siegel said she rarely went to the doctor, adhering to her physician father’s counsel that people shouldn’t go unless they’re sick. Although she hadn’t been to her doctor’s office in person recently, Siegel said she had corresponded with the practice staff, including keeping them up to date on her covid vaccination status.

After receiving the online dismissal through the patient portal for the Jefferson Health system, Siegel called the family medicine practice’s patient line directly. They told her three years was the protocol and they had to follow it.

“I asked, ‘What about the patient?’” Siegel said. “They didn’t have an answer for that.”

It was a month before Siegel, who has coverage under Medicare’s traditional fee-for-service program, could see a doctor who was accepting new patients. By that time, her stomach virus symptoms had resolved.

Jefferson Health doesn’t have a policy that patients lose their doctor if they’re not seen regularly, according to a statement from spokesperson Damien Woods.

However, he said, “Patients not seen by their provider for three years or more are classified in the electronic medical records as new patients (rather than established patients), per Center for Medicare and Medicaid Services (CMS) guidance. Whenever possible, Jefferson works with these patients to keep them with their primary care provider and offers options for new providers in certain circumstances.”

American Medical Association ethics guidelines recommend that physicians notify patients in advance when they’re withdrawing from a case so they have time to find another physician.

But the organization, which represents physicians, has no guidance about maintaining a panel of patients, said AMA spokesperson Robert Mills.

The American Academy of Family Physicians, which represents and advocates for family physicians, declined to comment for this story.

A primary care physician’s panel of patients typically includes those who have been seen in the past two years, said Phillips, of Harvard. Doctors may have 2,000 or more patients, studies show. Maintaining a workable number of patients is crucial, both for effective patient care and for the doctors.

“Practices realize that a major contributor to physician burnout is having more patients than you can deal with,” Phillips said.

Demand for physician services is expected to continue to outstrip supply in the coming decades, as people age and need more care at the same time the number of retiring physicians is on the upswing. According to projections from the Association of American Medical Colleges, by 2034 there will be a shortage of up to 48,000 primary care physicians.

Maintaining a regular relationship with a primary care provider can help people manage chronic conditions and promptly identify new issues. Regularly checking in also helps ensure people receive important routine services such as immunizations and blood pressure checks, said Dr. David Blumenthal, a former primary care physician who is president of the Commonwealth Fund, a research and policy organization.

Health care organizations increasingly focus on requiring doctors to meet certain quality metrics, such as managing patients’ high blood pressure or providing comprehensive diabetes care. In this environment, “it could be problematic for physicians to be accountable for the health of patients who do not see them,” Blumenthal said.

Money also figures into it. Steady visits are good for a practice’s bottom line. Practices may also decide to avoid new Medicare patients or those with certain types of insurance because the payments are too low, said Owen Dahl, a consultant with Medical Group Management Association, an organization for health care managers.

In general, doctors aren’t obligated to continue seeing a patient. A doctor might dismiss patients because they aren’t following clinical recommendations or routinely cancel or miss appointments. Belligerent or abusive behavior is also grounds for dropping a patient.

In certain instances, physicians may be legally liable for “patient abandonment,” a form of medical malpractice. State rules vary, but there are common elements. Those rules generally apply when a doctor harms a patient by dropping them abruptly at a critical stage of treatment. It would generally not apply if a patient has not seen the physician for several years.

Even though quietly dropping a seldom-seen patient might not have an immediate medical consequence, patients ought to be informed, experts said.

“It’s really good customer service to explain the situation,” said Rick Gundling, senior vice president at the Healthcare Financial Management Association, an organization for finance professionals. As for Siegel, he said, “This woman should not be left hanging. If you’re the patient, the physician should be proactive.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

link; https://www.doximity.com/artic...da-b648-c2cba4b3e140

I wonder if I’ve been dropped. Haven’t been to my primary care doctor in about 3 years myself, nowadays I just head to the Patient First Urgent Care right down the road. I get seen quicker and they have a pharmacy right on site and the out of pocket cost with an HSA isn’t too much more than going to the regular doctor.

^^^^^^^^^^^
You are missing regular labs so you can find problems before they get worse. My primary has same day appointments and knows me well. I have seen him for over ten years. I get seen on time because he is that kind of guy.

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three years was the protocol and they had to follow it.

Sounds a bit like the pediatricians that are 'unable' to see children after their parent rejects any of the recommended vaccinations.

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When Claudia Siegel got a stomach bug earlier this year, she reached out to her primary care doctor to prescribe something to relieve her diarrhea.

I get the drift of the story, but why not just go to the drug/grocery store and pick up some Pepto-Bismol?

Same thing happened to me. I hadn’t seen my GP for over three years simply because of no medical issue needing attention. When I did try to make an appointment I found that I was no longer her patient.

I told the scheduler that I’d like to get reinstated. Whew, that worked, thank goodness. Since then I’ve been careful to see her at least once a year. She’s a good physician, and very perceptive.

I'm an old guy with DaBeetus, and a few other aches and pains, I get lab work done every six months, and see my doctor the next day.

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I get the drift of the story, but why not just go to the drug/grocery store and pick up some Pepto-Bismol?

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Cause Pepto is over rated. Plus their commercials suck. Immodium and Limotil are much more effective. IDK maybe she wanted to be checked for C diff, a particulalry nasty bug that can be life threatening.

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Originally posted by 229DAK:
I get the drift of the story, but why not just go to the drug/grocery store and pick up some Pepto-Bismol?

I got food poisoning once and was vomiting and had diarrhea…frankly I couldn’t have driven to the corner for anything…called my doc, she called in a script for something and I had my big kid go get it. Whatever it was it stopped the vomiting & diarrhea immediately. I think it was Zofran.

Thanks for giving me Yet Another Reason to dislike the "health care" industry. (As if I needed another.)

Y'know how I read this?

quote:

Originally posted by ZSMICHAEL:
You are missing regular labs so you can find problems before they get worse.

"The practice and the system of which it's a part is missing regular income from you and your insurer."

I suppose I best reach out to whom I believe is still my PCP to see if she really is still my PCP <smh>

my primary care folks refused to see me when i had the Cooties because I had not been in maybe 3 yrs,

quote:

Originally posted by Pipe Smoker:
Same thing happened to me. I hadn’t seen my GP for over three years simply because of no medical issue needing attention. When I did try to make an appointment I found that I was no longer her patient.

I told the scheduler that I’d like to get reinstated. Whew, that worked, thank goodness. Since then I’ve been careful to see her at least once a year. She’s a good physician, and very perceptive.

A conscientious MD like that is worth the visit, a rare breed for sure.

quote:

Originally posted by ZSMICHAEL:
^^^^^^^^^^^
You are missing regular labs so you can find problems before they get worse. My primary has same day appointments and knows me well. I have seen him for over ten years. I get seen on time because he is that kind of guy.

Not sure what you mean by that

I do get a biometric screening every January/February as part of my health insurance; they take blood and do a bunch of screenings with it like cholesterol, blood sugar etc along with BP measurements etc so I do have a baseline from year to year.

^^^ You're not missing anything. Based on your 1st post, he likely assumed that you go to Urgent Care just for sick visits and were not getting regular blood works.

Yep. That is correct.

quote:

Thanks for giving me Yet Another Reason to dislike the "health care" industry. (As if I needed another.)

Y'know how I read this

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You are one cynical guy. I have my own business and am not owned by a hospital or corporate entity. I despise corporate health care and this is what the article is about. If you wish to treat yourself more power to you. I just suggested that it is good practice to have regular blood work to catch problems early on. I posted the article to give people a heads up on the coming shortage of primary care physicians and what is in the mix with corporate health care.

quote:

Originally posted by ZSMICHAEL:
You are one cynical guy.

I suppose I am. At least wrt to the U.S. "health care" industry.

quote:

Originally posted by ZSMICHAEL:
I have my own business and am not owned by a hospital or corporate entity. I despise corporate health care and this is what the article is about.

Well, then, I guess you're one of the very few remaining good guys. Or maybe it's just around here, because, around here I don't know if there are any independent PCPs left.

quote:

Originally posted by ZSMICHAEL:
If you wish to treat yourself more power to you.

Wish to? No, I do not wish to. But I increasingly feel I'm left with little choice.

I will be reaching out to (what was?) my PCP to find out if I'm still a patient. I have kept them in the loop with any and all medical issues relating to me since I last visited them, and they did recently renew my prescription for Lisinopril. So I'm probably still a patient. The thing that has me wondering is they haven't pestered me for a wellness checkup for well over a year.

Understand: My verbal arrows aren't and weren't aimed at you. It's more an expression of my general dissatisfaction the the U.S. health care system in general. It too-often seems more oriented toward being a health care profit system than a patient health care system.

Just went through this. Covid for 2 years, nobody got to go to the Dr. + not sick for another year.

I went through a year of litigation with an insane person that found an unethical lawyer and fought to stay out of jail over made-up accusations.

Took a toll, got an ulcer.

Kicker - it was a simple estate. Liquidate house and car. But, as I have said before, money does not change people, it reveals them.

Called my Dr. as I was in agony, told to pound sand. 30+ years with that guy, and he drops me. I asked his receptionist if this was soviet style medicine, I was in agony, so she gave me an appointment 2 months out. Bad choice/worse choice. It's what tyrants do.

I believe he was still pissed off when he started asking me about guns in the house, family insider info - and was starting to write notes. I told him notes ONLY for things germane to the physical issues at hand, no woke social equity stuff.

He didn't like that.

Found a new and better physician much closer to home. She worked me up, got an upper and lower scan and medication. Still wouldn't have got in for the preliminary exam by now with the original guy.

Trust me when I tell you - avoid an ulcer. The pain and associated symptoms are a whole body experience and not for the timid.

Always thought I was a carrier, never thought I'd get one.

After 3 years of no contact.... you become a new patient all over again. This is based on Billing/Insurance rules.

Re-admitting to the practice is by choice of the practitioner. If you had outstanding orders or requirements, one might be labeled as "non-compliant" and therefore a liability.

A simple med refill request resets the clock.

Andrew

Your Dr. may be a quack if there are more than 6 chairs in the waiting room.

Your Dr. may be a quack if they run from room to room seeing 10 patients an hour.

Your Dr. may be a quack if you never get to see them after your first visit and only see Nurses or Physicians Assistants.

These are the warning signs that indicate you are at a business rather than a medical care office.