Can Urgent Care Be the ‘Rebound’ When PCPs Break Up with Patients?

The practice of physicians dismissing patients from their care seems to be on the uptick in recent years, according to a new report in JAMA Internal Medicine. Roughly 90% of the 794 practices that were part of the study have “fired” patients in the past 2 years—with 8% saying they’ve terminated relationships with ≥51 patients in that time. The greatest portion of participants (67%) has let up to 20 patients go. Only 10% have not dismissed patients during the study period. The authors noted that the number of dismissals tended to correlate with the size of the practice—larger practices were inclined to dismiss more patients than smaller practices. The most common reason for severing a clinical relationship was disruptive behavior or behaving inappropriately with staff (81% of dismissals) or violation of chronic pain and controlled-substance abuse policies (78%). Serial no-shows, failure to follow medical advice, and neglecting to pay bills were also high on the list. Less prominent, but increasing: 6% of practices let patients go because they went to the emergency room, urgent care, or retail clinics too often. Given their propensity to consider urgent care already, it seems likely those patients will become more frequent visitors.