Divorcing my doctor: how to proceed without being That Patient
April 3, 2013 10:22 AM   Subscribe

My GP's practice has over the last four or five months has just not been filling my needs. That's the nice way of putting it, and I would like to keep it at that without flinging about claims of negligence. So I want to get away from them, but I have a serious ongoing medical problem that won't allow, say, a two-month wait between one doctor's appointment and another. So I need to have some dealings with them. YANMD, but if you are a doctor, which would be preferable: a patient saying, give me a referral, I'm out of here, or, your practice did or did not do x, y, z, please do these things properly and give me a referral to a specialist.

So, I hate confrontations. I'm also pretty sick. I also believe that my GP has been failing to provide information/service and this failure has contributed to my being in bad shape at the moment. I have an appointment this Friday. I could go the I AM RETIRED LAWYER NEGLIGENCE routine, but that usually brings zero joy. I could write a list of the things I see as problematic and present it to the doctor. I don't know. Doctors? Other med pros? What is the best way to present concerns over quality of care? What is the best way to say, 'yo, peace out, I gotta find somebody who can deal with my carcass'?
posted by angrycat to Health & Fitness (14 answers total)
I left a doctor by finding a new doctor and getting all my stuff transferred to the new doctor's office. No discussion. No drama.

Not sure if that's not an option for you, but I've done that more than once and it's never been an issue.
posted by ablazingsaddle at 10:33 AM on April 3, 2013 [17 favorites]

Do you need a referral to a specialist or do you need a new GP? Or both? I'm not sure why you expect to have a two month wait between doctors' appointments - when I've wanted to change PCPs, I just... called up and made an appointment with the new doctor (and told my insurance). Then I had the old doctor send over my records. No confrontation necessary! Just keep going to the old doctor (and, heck, keep asking for that referral, why not) until you can get in with the new doctor, then leave!

If you feel they're doing something actually negligent or unethical then you should leave AND complain, but I don't think you should complain and stay unless there's some seriously compelling logistical/insurance/practical reason to stay (e.g. you are in a rural area and you will have to drive 40 miles to the next closest doctor).
posted by mskyle at 10:35 AM on April 3, 2013 [1 favorite]

angrycat: So I want to get away from them, but I have a serious ongoing medical problem that won't allow, say, a two-month wait between one doctor's appointment and another. So I need to have some dealings with them.

You can just make the appointment with the new doctor, even if you have to make it some months ahead of time. Just tell them that you will be sending your records closer to the appointment date. Then continue seeing your current doctor as needed until you are within a few weeks of the new doctor's appointment, and then tell then you are leaving and need your records sent to the new doctor. Perhaps there is some complicating factor I'm not understanding, but this seems like the ideal way to go about making the switch.

I honestly wouldn't bother telling them all the things they've done wrong. If they are that bad a practice, they will not take criticism very well.
posted by Rock Steady at 10:39 AM on April 3, 2013 [10 favorites]

Any practice/business not run by idiots would prefer to know why you were unsatisfied with their care. You can send a letter to the practice manager if you don't want confrontation.
posted by treehorn+bunny at 10:40 AM on April 3, 2013 [1 favorite]

Depending on your insurance you may need to wait a month to transfer to another doctor's panel of patients. In some insurance plans doctors are paid based on the number of patients in their panel and it's incredibly difficult if not impossible to make a PCP change mid-month.

Start with a call to your insurance carrier to ask when you need to make the change. If you can make the swap at any time, then awesome. Then ask if they keep a list of physicians who are accepting new patients (some carriers do, some don't).

It's possible that you are stuck with the doctor you have for the month of April, but could certainly make a change for May. If that's the case, it's probably better to request exactly what you need. Going over history - especially if it's bad - puts people in a defensive posture. Instead, make direct requests for what you need until you can find a practice that's a better fit for you.
posted by 26.2 at 10:49 AM on April 3, 2013

Don't bother asking your current GP for a referral. You already don't like HIM, why would you like his referral?

Call your insurance co, see what you need to do to switch, then find a GP you like and switch. Before your first appointment, you'll get a form to sign that will allow the new office to get all of your records.

Don't bother discussing with your current GP, no good will come of it. If the office or if the Doc asks, you can just say, "I want to go in a different direction." I doubt they'll ask though.
posted by Ruthless Bunny at 11:43 AM on April 3, 2013 [5 favorites]

I once left a doctor (a specialist for a chronic condition rather than a GP, so MMV) of whose negligence I am certain, but not sure I could prove in a court of law. (Other medical professionals have hinted that I was right about him, but it's a fairly tight-knit community and I can understand their being loth to commit to anything.)

I didn't feel comfortable asking Old Doc for a referral, mainly because I had lost all faith in him at that point and didn't trust his judgment about other doctors. I asked my GP and friends for recommendations, and made an appointment with New Doc. I told New Doc's office that Old Doc "just wasn't a good fit for me," and that his practice had gotten so big that I didn't feel I was getting the care I needed. A few weeks before the appointment with New Doc, I called Old Doc's office and asked to have my records transferred, repeating the line about "fit."

Maybe it was chicken of me, but the town is small enough that I'm sure Old Doc and New Doc probably know each other and I just wanted to get it over with with as little fuss as possible.
posted by The Underpants Monster at 11:46 AM on April 3, 2013

The American Medical Association has a Doctor Finder web app that I found helpful when I moved to a new city and needed to find a new doctor. I would recommend just looking up a new doctor and possibly reporting any issues you've had with the state medical licensing board, that way you're not starting a lawsuit but there's a paper trail in case other patients have had other issues with the same physician.

posted by forkisbetter at 12:03 PM on April 3, 2013

Why on earth do you feel you owe your GP anything at all beyond bill payment? I usually buy my tacos from the guy down on Penn Avenue, but if I'm in Shadyside, I get them from the Mexican restaurant there.

Your doctor is just an expensively, long-educated worker you hired for a job. There are advantages to using the same one regularly (like he'll remember that you prefer extra jalapenos, or are taking antibiotics), but if you're seeing a new one you just special order that stuff.
posted by IAmBroom at 12:12 PM on April 3, 2013 [10 favorites]

Why are you still seeing your doctor if you don't like them? Just choose a new doctor. Your new doctor will have you sign a release to get all your records from the old doctor. To be honest, it seems unlikely you have a claim of negligence, unless your doctor really abandoned you while you were sick.

If you want to give constructive feedback, I'd write a simple letter, about 3/4 of a page, saying what you liked about the practice, and what you didn't like, in simple, factual terms, without saying negligence. Explain these are the reasons you decided to go with a different doctor.

I guess a final option, if you want to keep your GP but also get a referral to a specialist, and I think this might be your question, would be to call and say, "I believe I need to see a specialist in x, please give me a referral. Otherwise, I need to seek out the care of another GP who can give me that referral." But I'm not sure why you don't just call the office of the specialist directly either.

Good luck,

Signed, A Nurse
posted by latkes at 12:59 PM on April 3, 2013

Just do your Friday appointment as normal: don't ask for a referral and don't tell your doctor you're leaving. Then, find yourself a new doctor. Once you have someone you like, ask them to get your records transferred. You don't ever need to talk about leaving directly with your doctor or anyone in that office. It's totally normal to just switch providers.

I was in a similar situation (except the stakes were lower -- I wasn't particularly sick, just wasn't getting very good care) --- that's how I handled it, and it worked out fine. I also wrote the office afterwards explaining why I left.

My thinking about complaining: as I see it, the only purpose in complaining is to give someone the opportunity to get better. So I wrote a polite letter, saying what I liked about the practice and what I didn't, and why I'd decided to leave. They never wrote back and probably didn't do anything with my feedback, but I found it mildly satisfying anyway. Essentially it closed the book for me, and helped me stop seething about their incompetence :-)
posted by Susan PG at 6:39 PM on April 3, 2013

Okay, thanks folks. Your answers have helped me see that I need to choose my battles carefully and focus on my health, even though at this point I am sort of in Braveheart mode. Thanks again.
posted by angrycat at 4:56 AM on April 4, 2013 [2 favorites]

Also -- they may be glad to have you move on to someone new -- especially if they aren't willing to put the time in to figure out how best to treat you.
posted by vitabellosi at 7:10 AM on April 4, 2013

I once elaborated nicely (although I was crying while I did it) to a doctor all of the things that he could have done to make my situation bearable. He had made a mistake in my surgery and admitted it, but he also did not disclose a LOT of things to me beforehand that would have been preferable to learn as possibilities and not have them thrust on me as realities much later. I listed those things for him, although I started by saying, "You have a lot of patients and so inevitably someone is going to have a bad experience and I'm just sad it's me. I know that you come highly recommended by {my cancer surgeon}, so I know that in general you are good at what you do." Then I said, "But I wish that you had told me in advance (a), (b), (c)..." I had a list of about 8 things that had happened that should have been disclosed earlier.

I did it with the intention of helping him, and he knew it. He also knew that I could sue him for malpractice and that I was not going to do so. However, I did not pay him a cent above what my insurance paid him and his office stopped billing me shortly after this conversation (which was about 6 months after the mess started).
posted by janey47 at 12:05 PM on September 30, 2013

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