I think I'm a little sensitive about this subject because it comes up so often for me professionally.

I would never stop seeing a diabetic the first time they took their insulin wrong. I am going to meet with her (literally) every day if necessary until she gets her blood sugar under control. I am going to try a dozen different medications until we find one that she can tolerate. I am going to print off handouts from websites and discuss weight loss and draw pictures on a white board. But, after a few years of this- including multiple trips to the ER- I'm going to decide that I am just not the right provider for this patient. I'm going to recommend that she see someone else. It is clear that she and I just cannot communicate. I don't speak her language.

Substitue "asthma", or "heart disease" or "depression" for diabetes and this is my daily patient load.

Am I a bully for firing 2 or 3 patients in my 10 year career as a medical provider? Perhaps. But I just hope that their next doc was able to speak their language and reach them.

Finally, I look at myself. My own doctor has written me for pscyh meds and I choose not to take them. I just can't bring myself to. I am the master of my own fate, I am allowed to make my own choices. But, the day he has to visit me in the hospital is the day he gets to insist I start taking that med.

I bet this isn't very interesting to most people, but like I said it is very important to me. Thanks for listening to me rant.