Ethical Question: Physician Ghosting Patients

[YCP Pre-Med]

Hello! I realize we're in the thick of medical school applications and secondaries (hope everyone is surviving!), but I wanted to pose a question. I work in a local hospital system that serves a smaller community. The demographics being what they are, they do not have many specialists. One of the long-time Hematology/Oncology physicians is leaving the area. Sounds standard so far, right?

Here's the catch. The doctor hasn't told any of her patients that she's leaving. I couldn't believe it myself if I hadn't talked with some of her patients. When we told them about her last day, they were all shocked. They couldn't remember her mentioning it at all.

Assuming this is all correct, how should the doctor have handled transitioning care? I realize that this is on the extreme end of the spectrum (and I don't know the full situation). Is there any scenario where this is acceptable? Does anyone else have experiences with situations like this? I can't believe I'm telling a story about a physician ghosting her patients.

Thanks for stopping by!

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[Lannister]

This seems really strange. When my gastroenterologist left, I was given like six months of warning. It seems like it'd be especially important for a heme/onc doctor to give their patients advance warning, since people with cancer can't just not have a doctor.

 

[Inspired Chaos]

My kids' pediatrician left with no notice. We'd seen him for 7 years and it became a nightmare trying to get medical records because he literally abandoned his entire practice/building and quit medicine altogether. He was like 50, so it wasn't a typical retirement. Apparently he didn't even tell his staff. Just moved from Chicago to St. Louis one weekend.

We loved him and were super bummed.

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[banthapug]

Usually a letter goes out to everyone on the provider's panel. Often referrals to different providers are offered as well. I guess there is no law saying this has to happen, but it's just common courtesy and also covering up your ass.

 

[YCP Pre-Med]

My kids' pediatrician left with no notice. We'd seen him for 7 years and it became a nightmare trying to get medical records because he literally abandoned his entire practice/building and quit medicine altogether. He was like 50, so it wasn't a typical retirement. Apparently he didn't even tell his staff. Just moved from Chicago to St. Louis one weekend.

We loved him and were super bummed.

Sent from my SM-G950U using Tapatalk

This scenario is exactly what I'm envisioning happening. It's so sudden, makes me think there is more to this story. Apparently she's been in the area for years!

Usually a letter goes out to everyone on the provider's panel. Often referrals to different providers are offered as well. I guess there is no law saying this has to happen, but it's just common courtesy and also covering up your ass.

I was wondering about the legality of this too. As one of the posters mentioned in this thread already, patients with cancer issues can't just stop being seen. I would envision a pretty comprehensive pass off needs to take place. Honestly, I could see lawsuits coming out for negligent medical practice. I mean, how could you do that with people's lives on the line?

 

[ADSigMel]

My kids' pediatrician left with no notice. We'd seen him for 7 years and it became a nightmare trying to get medical records because he literally abandoned his entire practice/building and quit medicine altogether. He was like 50, so it wasn't a typical retirement. Apparently he didn't even tell his staff. Just moved from Chicago to St. Louis one weekend.

We loved him and were super bummed.

Sent from my SM-G950U using Tapatalk

A lawyer in my area did this a few years ago. It was insane! IIRC, he was the only partner, or at least one of very few seasoned lawyers, in his practice. Junior associates ended up in a trial-by-fire situation trying to pick up his slack.


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[Planes2Doc]

My PCP back home went silent, so after unsuccessful attempts to reach her, I decided to find another doctor. Eventually I received a letter saying she is no longer practicing, and had the contact info for another doctor. Then I read a story in the news that she got indicted on federal charges for Medicare fraud.

 

[raiderette]

Is she part of a larger practice? Will the hospital have access to records? This is a nightmare. I know I had problems with high school and college when I couldn't get access to immunization records if they didn't accept the dates or signature on my immunization card.

 

[YCP Pre-Med]

Is she part of a larger practice? Will the hospital have access to records? This is a nightmare. I know I had problems with high school and college when I couldn't get access to immunization records if they didn't accept the dates or signature on my immunization card.

That's the biggest problem actually. She does private practice. One of the only ones in the area. We are honestly scrambling on what to tell her patients. They have outstanding lab requisitions, care plans to follow through with, it's a mess. The fall out for her patients is tough to watch. She hasn't really informed anyone as to why she's leaving. We're left trying to help patients find other physicians and send their results to different offices. I'm shocked that someone could just up and leave with that much responsibility.

 

[Mad Jack]

Hello! I realize we're in the thick of medical school applications and secondaries (hope everyone is surviving!), but I wanted to pose a question. I work in a local hospital system that serves a smaller community. The demographics being what they are, they do not have many specialists. One of the long-time Hematology/Oncology physicians is leaving the area. Sounds standard so far, right?

Here's the catch. The doctor hasn't told any of her patients that she's leaving. I couldn't believe it myself if I hadn't talked with some of her patients. When we told them about her last day, they were all shocked. They couldn't remember her mentioning it at all.

Assuming this is all correct, how should the doctor have handled transitioning care? I realize that this is on the extreme end of the spectrum (and I don't know the full situation). Is there any scenario where this is acceptable? Does anyone else have experiences with situations like this? I can't believe I'm telling a story about a physician ghosting her patients.

Thanks for stopping by!

That's patient abandonment and can cost you your license. You are supposed to provide your patients with both notification you are leaving and do your best to refer them to someone else. Each state has different requirements regarding what is reasonable, but it is generally a month to sixty days.

 

[YCP Pre-Med]

That's patient abandonment and can cost you your license. You are supposed to provide your patients with both notification you are leaving and do your best to refer them to someone else. Each state has different requirements regarding what is reasonable, but it is generally a month to sixty days.

Honestly, this is what I thought existed. After practicing for decades, I get the sense she's not worried about losing her license. It's just so bizarre. Most of her patients respected her and her clinical acumen, which is why I'm shocked she just up and left. I know some of her patients personally and they are left scrambling to find a physician to pick up they're care.

 

[Mad Jack]

Honestly, this is what I thought existed. After practicing for decades, I get the sense she's not worried about losing her license. It's just so bizarre. Most of her patients respected her and her clinical acumen, which is why I'm shocked she just up and left. I know some of her patients personally and they are left scrambling to find a physician to pick up they're care.

What is Patient Abandonment?

Just the basics on what this is and why it is considered malpractice. If her patients suffer harm, they could even sue for damages, depending on the circumstances.

 

[YCP Pre-Med]

What is Patient Abandonment?

Just the basics on what this is and why it is considered malpractice. If her patients suffer harm, they could even sue for damages, depending on the circumstances.

I'm not trained in medical law, but this seems to fit the bill. I guess the injury aspect is tbd. I would hope there aren't any patient injuries as a result of this, but it's frustrating that she could get away with this kind of negligence.

 

[Mad Jack]

I'm not trained in medical law, but this seems to fit the bill. I guess the injury aspect is tbd. I would hope there aren't any patient injuries as a result of this, but it's frustrating that she could get away with this kind of negligence.

She shouldn't. If I were in medmal, I'd have her damn head.

 

[Catalystik]

Is there any scenario where this is acceptable?

Sometimes a doc's abrupt departure is not a choice. I've seen it happen that a doc in his 40s died of a heart attack while jogging, one who lost normal function in an operating hand due to an unsuspected brain tumor (dead within the month), and another who had a stroke in his 30s that caused overwhelming cognitive and gross motor damage. Hospitalization for psychiatric or addiction issues might be another possibility. The doc's staff would have no clue what to do, but the hospital might step in by hiring a locum tenens to cover the patients until they find out what's going on. Or by providing the staff with a list of oncologists in the region to whom care might be transferred.

 

[YCP Pre-Med]

Sometimes a doc's abrupt departure is not a choice. I've seen it happen that a doc in his 40s died of a heart attack while jogging, one who lost normal function in an operating hand due to an unsuspected brain tumor (dead within the month), and another who had a stroke in his 30s that caused overwhelming cognitive and gross motor damage. Hospitalization for psychiatric or addiction issues might be another possibility. The doc's staff would have no clue what to do, but the hospital might step in by hiring a locum tenens to cover the patients until they find out what's going on. Or by providing the staff with a list of oncologists in the region to whom care might be transferred.

Interesting. These scenarios seem reasonable. I hope that they are able to get a temporary physician to cover, but this is definitely an underserved area. It's rough because there are so many pieces to pick up. Where do you report critical results too? Whose following through with scheduled visits?

To make things worse, there are a fair amount of rumors going around. People saying there was a malignant work culture (ex Physician ripping staff a new one for mistakes). Constant turnover of employees.

 

[jm192]

What exactly is your role?

It's odd that you know, you know her patients don't know, and you're the one informing them.

 

[Catalystik]

there are a fair amount of rumors going around. People saying there was a malignant work culture (ex Physician ripping staff a new one for mistakes). Constant turnover of employees.

She may have been given the option of resigning vs having an action brought against her by the hospital or through a local medical association.

 

[YCP Pre-Med]

What exactly is your role?

It's odd that you know, you know her patients don't know, and you're the one informing them.

I work in the laboratory (glorified phlebotomist), in both inpatient and outpatient locations. I talk with patients all the time, asking how they are doing and sometimes they'll tell me how their treatment is going. This is a very bizarre situation. That's one of the reasons I made this thread. We have been told to not talk with patients about her leaving (the hospital system doesn't completely know how to handle it).

She may have been given the option of resigning vs having an action brought against her by the hospital or through a local medical association.

Could very well be, but see my response above. I feel weird that I have been told to not talk about her leaving. This has been sending big waves through the area because of a lack of oncologists locally.

 

[jm192]

I work in the laboratory (glorified phlebotomist), in both inpatient and outpatient locations. I talk with patients all the time, asking how they are doing and sometimes they'll tell me how their treatment is going. This is a very bizarre situation. That's one of the reasons I made this thread. We have been told to not talk with patients about her leaving (the hospital system doesn't completely know how to handle it).



Could very well be, but see my response above. I feel weird that I have been told to not talk about her leaving. This has been sending big waves through the area because of a lack of oncologists locally.

How do YOU know? Not to be ugly, but if I'm an admin, lab people wouldnt be privvy.

 

[YCP Pre-Med]

How do YOU know? Not to be ugly, but if I'm an admin, lab people wouldnt be privvy.

In my outpatient role, I have to register patients electronically. That means I need a requisition with a physicians signature (among other things). We cannot accept orders from physicians who are no longer practicing, which means we need to be privy to who is and is not practicing in the area. For cancer patients, they NEED their results to be interpreted by a physician responsible for their care. So I'll ask you, where do I send them? Who do I send them too? What do I tell patients when they ask where their oncologist went?

As a side note, this would be an interesting situation to discuss in secondaries. I would rather this situation had not happened though. I feel for the patients who are scrambling. Stepping into this mess again tomorrow at work.

 

[Bacchus]

This sounds like abandonment to me. There's no indication there was appropriate warning given. Assuming from your handle the state you are in, it's 30 days notice.

 

[YCP Pre-Med]

For those of you familiar with what's going on, I just got an email with these questions today (it's a script if we get an order):


You have an order from Dr. M. Are you aware that Dr. M’s office practice is closed? We will need to send your results to another physician. Where would you like us to send your results?
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We have a list of several oncologists in the area. Would you like contact information about these physicians?
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(If they ask what happened to her practice) We do not have any further information about Dr. M’s practice. Her telephone service is still in operation and you may direct questions to that line: ###-###-####


This is so weird because they expect us at the lab to give referral suggestions? No warnings and no communication. Blows my mind that this type of negligence and lack of communication can occur, and in healthcare no less.

 

[Christina’s Consideration]

I wrote this article a few months ago and it might at least answer the initial question ... in part. While it could be a privileged issue, it could also be related to s contract between the doctor and hospital or clinic.

To me, a good question. Is would you sign a contract with these clauses? Ghosting: Tips for when your doctor disappears