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    Anger is fraying the doctor-patient relationship

    Kelly Collins, MD, often hears patients venting about high copays and insurance denials.  Many are working people who earn too much to qualify for Medicaid but too little to afford good-quality health insurance, and they are angry that their plans cover little of the care they need.

    “A lot of my patients are struggling,” says Collins, who runs a solo family practice in Bellevue, Nebraska. “One little thing can push them over the edge.”

    Collins is not alone. A large portion of the 145 physicians who responded to an exclusive Medical Economics poll reported that they are seeing greater numbers of angry patients these days. Compared to their practice environment a year or two ago, 87% reported an uptick.

    Paying for care is the main spark of the anger, the survey found. Among physicians seeing more angry patients, 56% said the cause was financial concerns, such as high copays or deductibles.

     

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    Other factors are adding to rage that’s simmering in physicians’ offices, the survey found. “Inability to get desired prescriptions” was the second-most cited reason in the survey, mentioned by 12% of physicians. In some cases, the desired prescriptions were for opioids. For other patients, they were for drugs not covered by their insurance or for which their share of the payment was more than they could afford.

    Psychiatrist David Reiss, MD, often saw patients who were angry they could not get access to needed drugs during his two decades working in the California workers’ compensation system. Some of these
    patients were pushed out of needed treatment, denied medication the system no longer would cover or forced to wait months to get a prescription filled.

    “In workers’ compensation, the whole system is broken,” says Reiss, of Rancho Santa Fe, California. He finally left in frustration and now gives seminars on treating difficult patients, in addition to running a private practice.

    Given the frustrations they are witnessing, many physicians are finding it is more important than ever to have plans in place to respond to angry patients in a constructive way.

    Next: Planning ahead

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