I recently learned about "ghosting patients" - a term used when patients find their physician (or other provider) has left a practice/clinic/medical group/hospital/etc and they don't know how to find them. This often happens due to some sort of separation like leaving to start one's own practice/group, moving to a new practice/group or being fired -- with or without cause. Ghosting usually arises due to contract clauses and the medical group or practice to lose that physician's patients. But to patients, it feels like their physician has disappeared into a puff of smoke.
It got me thinking and I wrote an article on it for healthcare leaders to understand the impact on patients. I also considered reaching out to patients and their family caregivers who might be perplexed and not understand what options are available. It all comes from my personal belief that no one should tell me who I can, or can't, see as my physician. Well, other than insurance companies who tell us who is in network and who isn't. Even in these cases, we can see who we want, but they might not pay for the fees.
So, what can/should you do if you call and find your physician is no longer practicing at that number, or you show up for an appointment and there is a new physician in his or her place? My answer is to advocate for yourself. If it doesn't bother you to see the new physician, and you actually want to try someone new, then see one recommended or suggested by the office.
If you want to continue seeing the same physician for continuity and the trusting relationship you have built, then inquire about where you doctor has gone. Perhaps they have moved out of state, changed their practice or retired and you don't have much choice to see them again. The office staff should be able to tell you something, even if it is a generic "he/she has moved to another practice."
My tips for what to do next are listed below. It may take some extra effort, but it may be worth it to you. The text in red are keywords to use that will get the attention of most administrators. Not everything will apply in all situations, so use what makes most sense to you.
- Ask around or Google the name of the physician you want to continue seeing. Is their new office within your travel circle?
- Once you find the new office, call to schedule an appointment. If you are told the physician can no longer see you, ask why. Ask if it is due to a clause in his/her contract at their prior location.
- If it is a contractual clause, call both locations - the previous office and the new one - and focus on quality and safety reasons for you to continue care with your existing physician. Be prepared to explain why you feel you need to continue with that physician. Reasons can include:
- you have a complex set of health conditions or a carefully constructed treatment plan.
- the physician is uniquely qualified and competent to treat your specific disease or set of conditions.
- you and the physician have built up mutual trust and a routine that has kept you safe, on track for recovery or avoided a deterioration of your health.
- you believe there hasn't been an adequate hand-off process.
- Ask the existing practice to share with you the information that demonstrates any of their other physicians are qualified and competent in treating your condition(s).
- By this point, you will hopefully have an appointment with the physician of your choice. If there are still objections related to the contract and non-compete clauses, then
- ask to speak to the person is is responsible for ethics in the practice
- ask for the process for filing a grievance
- Ask how the prior practice/group plans to force you to continue treatment in the practice
- ask how they plan to enforce non-compete clause of the contract; and mention a recent Kaiser Health News article; noting that courts are hesitant to uphold and enforce some non-compete clauses because they don't like denying patients their choice. (A precident!)
- let the practice that employed the physician know you look forward to completing your next patient satisfaction survey. Increasingly, insurance reimbursement (especially Medicare) is tied in part to patient satisfaction.
- Hospitals, clinics and medical groups that are licensed or accredited are required to hang these documents where they can be easily seen by the public. Look for these documents and call and file complaints. State licensing agencies, the Joint Commission, Accreditation Association for Ambulatory Health Care and other certifying organizations regularly assess the quality and safety of care provided. Complaints and patient satisfaction are included in their decisions.
- If you are a Medicaid or Medicare patient you can also file a complaint or grievance.
- Go online and make some noise. Clinics, medical groups and even small physician practices are increasinging concerned about their Yelp reviews. The two most popular physician rating sites are Healthgrades and Vitals
Most importantly, use your own words to convey why it is important for you to continue seeing your current doctor. Insert any of the keywords that are relevant to your situation. If you find that any of these or other techniques work, please share them below.
At some point in the process of following your physician, you may also need to request a copy of your medical record from the previous practice or medical group. Talk to your physician to see how much he/she needs or wants.
Most importantly, advocate for yourself!
Update: I was recently interviewed for an article in the American Bar Association Journal on this topic. Please reference it as well.
An increasing number of physicians are dismissing patients, but are they doing it legally?
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