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Thu Aug 21, 2014, 02:10 PM

Should your Doctor be able to force you to "x" number of appointments?

I was recently unpleasantly surprised when my Doctor's office told me that I would be required to have at least one appointment every three months, rain or shine. If I didn't fulfill that quota I could be dropped as a patient.

I was also surprised at the number of comments I received on a posting about this which appeared to approve of this practice. Only a small number were shocked, as I had been. So this poll:

Do you agree that your Doctor can require you to a minimum number of office visits per year? (If you don't comply you will be dropped as his/her patient)
16 votes, 0 passes | Time left: Unlimited
I somewhat agree
1 (6%)
I completely agree
0 (0%)
I somewhat disagree
0 (0%)
I completely disagree
15 (94%)
Other
0 (0%)
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Disclaimer: This is an Internet poll

32 replies, 2287 views

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Arrow 32 replies Author Time Post
Reply Should your Doctor be able to force you to "x" number of appointments? (Original post)
COLGATE4 Aug 2014 OP
Gidney N Cloyd Aug 2014 #1
SharonAnn Aug 2014 #2
Aristus Aug 2014 #7
Gormy Cuss Aug 2014 #15
Tuesday Afternoon Aug 2014 #23
redqueen Aug 2014 #24
notadmblnd Aug 2014 #27
NightWatcher Aug 2014 #25
Tikki Aug 2014 #3
TheKentuckian Aug 2014 #4
mainer Aug 2014 #5
pinto Aug 2014 #6
stevenleser Aug 2014 #8
cbdo2007 Aug 2014 #9
mainer Aug 2014 #10
closeupready Aug 2014 #11
Iggo Aug 2014 #12
csziggy Aug 2014 #13
lunasun Aug 2014 #14
Xithras Aug 2014 #16
HockeyMom Aug 2014 #17
lunasun Aug 2014 #21
Ms. Toad Aug 2014 #18
gollygee Aug 2014 #19
La Lioness Priyanka Aug 2014 #20
aint_no_life_nowhere Aug 2014 #22
Erich Bloodaxe BSN Aug 2014 #26
Shrike47 Aug 2014 #28
SickOfTheOnePct Aug 2014 #29
LiberalArkie Aug 2014 #30
LuvLoogie Aug 2014 #31
jwirr Aug 2014 #32

Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:14 PM

1. Dr's offices are filled with sick people. Why would I want to make more trips than I need?

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:16 PM

2. Depends on the situation For example:

If you have a chronic disease that requires monitoring and testing, then a doctor might require this to encourage a level of compliance with the medical treatment.

One case: A diabetic whose blood sugar was not controlled, only went to the doctor when he had a noticeable problem. Despite the warnings, the information, and even the lectures, the patient refused to do what was necessary and take the medication that was provided. Naturally, the end was not good. Lost his legs, then heart attack while recovering. I could see a doctor setting the ground rules for compliance with medical treatments.

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Response to SharonAnn (Reply #2)

Thu Aug 21, 2014, 02:21 PM

7. ^^^THIS!^^^

Thank you, SharonAnn.

Now, I don't 'require' my patients to fulfill a certain number of office visits. I recommend them based on the severity of their chronic condition, and on the type of treatment protocol is indicated for it. I say to my patients: "I'd like to see you back here in 3 months so we can check your A1C and cholesterol levels again. We'll see if there's any progress." - not: "Get your ass back here when I say so, or I'll rage-murder you and your whole family so hard no one will even remember you!"

Yeah, there are some doctors out there with bad bedside manners. Find another provider.

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Response to Aristus (Reply #7)

Thu Aug 21, 2014, 02:34 PM

15. And that is why "required" is the wrong word to use.

If patients understand that it's in their best interests there is an incentive to come back.

However, medical professionals must also be sensitive to factors that may be making the patient resistant like cost not just for co-pays but for uncompensated time off work and negative work scores for being unreliable, or the difficulty of getting to a doctor's appointment for people who don't own cars or can't drive.

If a patient has such concerns, perhaps the patient and provider can work out an alternative but that's not going to happen if the provider takes the my-way-or-the-highway approach.



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Response to Gormy Cuss (Reply #15)

Thu Aug 21, 2014, 05:14 PM

23. Yes, it should be a team effort/approach. and The Doctor should be on the Patient's team and not

the other way around. All patient's have rights and they should be respected.

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Response to Gormy Cuss (Reply #15)

Thu Aug 21, 2014, 05:19 PM

24. Excellent post, well said. nt

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Response to Aristus (Reply #7)

Thu Aug 21, 2014, 05:42 PM

27. My problem is with finding a chronic condition in everyone

Drs. don't seem to want to heal people any longer. They want to find chronic conditions then convince people that they need certain meds in order to live. Then they keep you running back every 3 months in order to get the meds you have been told you need to survive.

Then, you can't actually get into see your Dr. when you're sick because the Dr is all filled up two weeks out. So you go to urgent care when you're sick, and pay a higher copay. Then on your followup 2 weeks later, because you couldn't actually see your Dr when you were sick, you go to the office, sign in and sit in the waiting room. I guess Drs finally paid attention to patients complaints about the long waits in the waiting room and now they take you in right away and then you wait for over an hour for the Dr to come into the exam room. Then you're told you went to the wrong urgent care facility because your Dr is not affiliated with them and there is nothing they can do but tell you that you need a bunch of tests and give you referrals to all their Dr friends for things you didn't go to the Dr for. All the while ignoring the fact that you went for a follow up for when you got sick in the first place.

I don't have the time or the personality to run around town to get the run around from Drs and their employees (snotty receptionists mostly) who act as if they are doing you a favor by letting you wait in one of their exam rooms to see the Dr.

Oh, and don't forget to pay first.

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Response to SharonAnn (Reply #2)

Thu Aug 21, 2014, 05:25 PM

25. ^^^^^ What you said^^^^^

I have a chronic disease (3 actually) and am on some strong meds and oral chemotherapy that may do damage to my kidney and liver, so I have to have blood work done every 3-6 months. If I refuse to do so, my Dr will not continue to authorize refills for the meds.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:18 PM

3. If you are on specific meds I can understand why a Doctor may want a visit with routines...

Just to say HI, not so much...


Tikki

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:19 PM

4. Not exactly but we can't pretend some medications don't require regular monitoring to

safely prescribe so it is reasonable to say no refill until you are seen sometimes but no I don't agree with ordering people in for visits at any time.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:20 PM

5. If doctor wants to monitor you, you refuse, and you have a bad outcome

you might turn around and sue him. That's what he's worried about. If you're a noncompliant patient who's hellbent on making yourself sick, then no doctor wants you as a patient.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:21 PM

6. Depends on the condition(s) being addressed and the established standard of care, I assume.

And, iirc, there are prescribing guidelines for chronic conditions. Those, I think, are every six months at a minimum.

I have to be seen every three months by my primary, at least annually by a specialist

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:21 PM

8. I agree with others that say it depends on the situation. If it's your gen pract and there is no

 

specific medical reason why the general practitioner is doing this, then it is wrong.

However, there are definitely reasons why it may be medically indicated to require to see you every few months or even few weeks and if a patient isn't keeping up with that, the doctor may want to drop the patient so as not to enable a patient not taking the proper care of themselves.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:23 PM

9. What kind of doctor?

I work with many psychiatrist offices who require this to make sure their patients are compliant with their medications and treatments.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:24 PM

10. You can always leave his practice. It's not like you're a slave.

Just like he's not your slave.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:27 PM

11. It's a free country, and he can implement such a rule if he wants.

 

But would I be likely to continue seeing him? Nope.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:28 PM

12. I pay my premiums. That's enough for Kaiser.

In fact, they send me a monthly mailing telling me how to avoid going to the doctor.

They seem to be happy to sit back and collect my premiums.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:29 PM

13. I'm ambivalent about this

I go through periods when I feel good and haven't had a recent injury and just don't want to see my doctor. But I think he can treat my problems better if he has seen me on a regular basis.

I know my veterinarian really likes that I have her come on a regular schedule to vaccinate and worm my horses. That way if they are sick or get an injury she is familiar with the animals and can diagnosis illnesses or get a better read on how badly injured they are. She also gives preference on emergencies to customers who use her for routine services, so my horses get treated faster when there is a real problem. And she knows that if I call about a colic, it is not because the horse was no wormed regularly so she can immediately rule out that as a cause.

I think human doctors are beginning to pick up how important this is for preventative care. Since this is finally beginning to be a priority in human medicine, that could be part of it. Also, more people are on more drugs for preventative care and many of those need routine monitoring.

So I don't object too much about seeing my GP for routine visits, though every three months seems excessive. But I don't see why I need to go see my dermatologist every six months when I have no ongoing skin problems he needs to treat - and have to pay a bunch for each visit that forces me to wait over an hour to be seen for five minutes.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:31 PM

14. It has been going on for a while in the new corp med care. They are forcing out private practice wit

Individual opinion this way too. Doctored will not make the decision . You are assuming the doctor is making this required when actually the group is telling doctors they will lose pay if they can not meet pt goals on compliance


Also there will be a new entity I have heard about in meetings
Someone who calls or visits to keep tabs on if you are complying with recommendations
Doctors would have to drop pts based on a third party opinion !! Well or not get paid I guess

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:35 PM

16. My doctor requires one visit every 18 months, and has for as long as I can remember.

I didn't see him for two years once, and had to apply again as a new patient when I visited. Good doctors generally limit the number of patients they accept, and they don't want to waste a "spot" on a patient who isn't serious about maintaining their health.

That said, every three months is pretty low. I've heard of doctors requiring one or two visits a year, but four seems a bit high.

So I agree with the concept, but not with your doctors specific policy.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:43 PM

17. I don't have a doctor

and this is one reason why. I learned this lesson with workplace "Your Health, Your Choice" (MONETARY penalization for not COMPLYING)" Wellness Program.

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Response to HockeyMom (Reply #17)

Thu Aug 21, 2014, 04:43 PM

21. Another example Of monetary punishment for non compliance I forgot about

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:48 PM

18. It depends on the circumstances.

There are medical conditions that require frequent treatment. Some examples: diabetes, post-transplant care, post-thrombosis care, uncontrolled hypertension. Some medications are unsafe when not monitored regularly.

Doctors may be reluctant to keep a non-compliant patient on, when adequate care requires more frequent visits than the patient is willing to make - because continuing to order medicine without proper monitoring is dangerous (and might even be malpractice).

If a doctor tried to require me to visit more frequently than medically necessary, on the other hand, I would start looking for another doctor.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:51 PM

19. I have to go at least once a year

for a yearly physical. That seems like a reasonable requirement to me. I can see them wanting to have patients who are actively taking care of their health, and being checked on every so often can be a part of that, but every three months seems like more than necessary. I would be OK if my doctor said every 6 months though I think.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 02:54 PM

20. i would like to know why. if they say this to collect more insurance money, i would think something

 

was wrong. if its because i have a chronic condition, that requires a certain number of visits, i would think the doctors office was in the right.

sorta depends.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 05:07 PM

22. There are a lot of things doctors do that sicken me - like requiring me to sign an arbitration

agreement as a condition of getting medical care. It means I can't file a case for malpractice and have it presented before a jury of my peers but instead have an individual decide it. Who chooses that arbitrator (who depends on recurring business from doctors and might be biased) and what is his background? Here in California, a doctor can legally refuse me as a patient if I don't want to sign away my rights to a jury trial. I have yet to meet a doctor who doesn't require this form.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 05:29 PM

26. I think I see my family doctor about once every 4-5 years.

I sure as hell couldn't afford to see him 4 times a year unless somebody else was paying all the bills.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 06:10 PM

28. I take opiates, although not a lot, and must see the doc at least every 90 days.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 06:13 PM

29. Truth is

No doctor can force you to visit him or her. All they can do is drop you as a patient, which is their right.

Not a great bedside manner, but their call.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 06:28 PM

30. My problem was after surgery. Insurance paid for 6 follow-up visits

So I was doing alright after surgery, Went to the 1st one 2 weeks after surgery. Doc said everything is alright come back in 1 month. 3 minute visit. So I drove the 150 miles a month later, 3 minute visit and doc said everything ok. Come back in a month.
I drove 150 miles the next month for the same 3 minute visit. Never made the next appt. BTW the visits were 3 minutes with a 2 hour waiting room wait.

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 08:26 PM

31. The OP is not telling the whole story.

What insurance? Family Practice? Cardiologist?

Are you in good health?

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Response to COLGATE4 (Original post)

Thu Aug 21, 2014, 08:46 PM

32. Like it or not if you want medicines renewed you will visit your doctor and if I am not mistaken it

is not the doctor who is making you come. It is often the law and it could also be insurance - either yours or the doctors insurance. No doctor in his/her right mind would prescribe drugs without following up on them.

Also health care has changed. We have gone from go to the doctor when you are sick to preventative health care. The latter requires us to make more visits such as yearly physicals. They are doing it to save money.

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