I'll go months without dismissing or firing a patient from my practice. I've had three this week, and it's enough to make me step back and ask, "Is it me?"
The first patient was an 18 month old fired because his father called one of my staff members a "bitch" after she asked them to reschedule their well child appointment because they were more than ten minutes late. I discussed the situation with the dad on the phone later in the day and it basically came down to that we could have resolved these issues except for calling one of my employees a bitch. That's just unacceptable.
The next was a similar case of involving the mother of a two year old who arrived more than ten minutes late for a sick visit. A different person on my staff, someone fairly new, but with incredible potential and who we'd like to keep around for years to come , bent over backwards to fit her in for an appointment later in the day. This staff member was left sobbing when the mother refused this appointment and went on her own tirade against my staff calling her unprofessional.
One other note on these late patients. All patients are asked to arrive ten minutes before their appointment time which means if they're more than ten minutes late they've really arrived more than twenty minutes later than asked. I really do my best to run on schedule out of respect to my patients, but nothing will throw my schedule off more than seeing patient who doesn't show their own courtesy to come on time. Once more my staff knows there are always extenuating circumstances in which I'll see someone who has arrived late, but there was nothing extenuating about either of these cases.
The third patient I dismissed over the phone yesterday. A young woman whom I'm convinced exhibits signs of prescription opioid addiction and drug seeking behavior, but lacks the insight to see this. She called me on Thanksgiving Day to ask me to call in a narcotic for her headache and the day after she wanted pain meds for her low back back. Both times I explained my policy of not calling in narcotics during off hours and I recommended she be treated at a local urgent care clinic or ER, or she could make an appointment with me at the start of the week all of which were unsatisfactory options to her. She said maybe she should go see another doctor and given the unraveling of our doctor-patient relationship I told her I thought this was for the best.
So is it me? Am I setting the bar too high here or was it just a tough week?