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Is “Firing” the Patient an Unintended Consequence of Value-Based Payment?

How frequent is the practice of “firing” patients? Research is sparse, but one recent survey found that one-fifth of pediatricians said they had dismissed families for refusing childhood immunizations. If you Google “firing patients,” you’ll find discussions about whether physicians and group practices can fire patients, under what circumstances, and how physicians can do so ethically and legally.

For example, the Texas Medical Association advocates firing patients “if the noncompliant or difficult patient continues to misbehave” (emphasis added), and the American Medical Association has guided physicians on how to avoid charges of abandonment when ending relationships with patients. Patients are fired for various reasons, including when they

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