Patient Dismissal in Texas

A patient has the option to change dialysis clinics or physicians whenever he/she chooses. Dialysis clinics have the right to refuse to accept a new patient or to continue treating a patient under a very few specific situations which are addressed in previous posts to this thread.

Although not addressed in the Conditions for Coverage because that regulation is only for dialysis practice, physicians have the right to “fire” a patient. This is an interesting article related to that topic that addresses legal and ethical issues.
http://www.physiciansnews.com/law/202.html

In the case of dialysis, a patient must have a treating physician to write dialysis orders, monitor the patient’s health status, and to participate on the interdisciplinary team in assessing and planning care for the patient. If a patient loses his/her treating physician, he/she would need to have another doctor to take over these responsibilities. The first place to look to have the least amount of disruption would be any other doctor that treats patients at that dialysis clinic or the patient would need to get a doctor and transfer to the clinic where that doctor practices.

Great news! The patient in Texas has been assigned to a clinic and will be receiving dialysis on a regular basis. When I talked to the patient on the phone, I was told the patient was accused of clamping a line and causing air to back up into the machine - patient talked to manufacturer and manufacturer said that couldn’t happen. Also the doctor expressed dismay that the patient wasn’t reaching dry weight - patient says this was due to weight gain. We can be happy a tragedy has been avoided!

That’s great news, Plugger. :slight_smile: Now I wonder if this person might feel more control over his/her destiny with home treatment?

Hi Beth,

Thanks for reply, just sounds kind of harsh, especially with all dialysis patients have to deal and adjustments to make to a new way of living with a life-threatening condition. And sad but then I don’t know the situation.

I remember during my first week of treatments in the hospital where a lady was being dialyzed next to me, she was so sick but she didn’t want to be there and was using so much profanity and being so rude to everybody, especially the tech. I was in shock a patient would behave that way. but this article said a NON-violent patient was dismissed.

who knew…
take it easy.

Plugger,
Yes, that is great news! It never should have happened but happy this poor person is receiving treatments again.
thanks for the info. take care.

I’m sure the shock was on both sides, Eagle Eye. We don’t know what kind of person this patient was before her kidneys failed (maybe she was always profane and rude), but we do know that finding out that your kidneys have failed is a tremendous shock that causes strong emotional reactions. It’s not uncommon to be angry (even enraged), depressed, grief-stricken, terrified… And dialysis clinics often don’t do much to acknowledge these feelings and help people through them, or even explain what’s going on and what to expect, to reduce the fear. There are generally at least two sides of every story, and Beth and I are always concerned when we hear things like “difficult patient.” It tends to be a difficult relationship between the patient and the clinic staff. It takes two to have a conflict.

Absolutely Dori!

I can attest to all of those emotions personally and I am still there with many of those emotions. However, I control my tongue. So that is why I was surprised at the patient’s behavior. Even so, my heart goes out to the patient, not the clinic. I am only trying to make sense of why a clinic would dismiss a patient and if their only argument is the patient was difficult, then they might as well get out of the medical profession altogether if they can’t deal with a difficult patient. We all have the potential to be difficult when sick including the doctor’s. Noone is exempt. It’s mind boggling to me a patient would even be dismissed in the first place.
And that it is so true that they don’t help the patient deal with losing their kidneys. It’s a huge loss. I didn’t drink, smoke, I ate healthy foods, etc., because I thought it would give me a chance at a healthy long life. So when I lost my health to RA and now lupus kidney the blows were devastating. It felt like the hospital just threw me to the wolves to fend for myself and when you get to the dialysis clinic, the atmosphere there is full of office politics, overworked nurses and techs, loud beeping noises, people yelling, chaos, time restraints, patients are treated like cattle, etc., etc., all while you are emotionally trying to come to terms with your loss. It’s just been since April '09 for me but I had no idea people were being treated like this and that the healthcare field was so insensitive. Afterall they are supposed to be caregivers. It is all news to me and sad at that

Dialysis clinics can have a culture that is a lot more like a custodial institution than a healthcare setting. This doesn’t always lend itself to sensitivity about people’s feelings. :frowning:

well yeah, so I have experienced…that’s too bad.

As I said the patient in Texas is safe and secure - and now getting a lawyer. We have decided in the interests of public safety to release the name of the doctor responsible on DialysisEthics, and we have found something already about the doctor that gives us concern.

Plugger,
Yes, I responded last week to that. That’s great news. It never should have happened in the first place but happy to hear there was a positive outcome in the end…

We can be glad there has been a positive outcome, however we are concerned about something similar happening to others - that’s why we put the doctor’s name up and some of his past history. I was leery of doing it at first and talked to Arlene about it. She strongly believed we ought to do it, so I put it up.

Arlene has been at this for 11 years, has some very experienced legal and media help - and I would trust her with my life. If Arlene has alarm bells going off about this doctor, at least on our end the posts will stay.

The dismissed patient in Texas has decided to go public with her story:

In the “Stories” section of our forum
http://www.dialysisethics.org/forum/

Outstanding, I could not agree more.