My Psychiatrist's Office Dropped Me

I received a certified letter from my Psychiatrist's office stating that they decided to drop me permanently as a patient for missing 2 appointments. Mind you the 2 appointments were 3 YEARS apart, and I knew nothing about this policy. I was suppose to go in for New Patient registration like 2 weeks ago, but with everything happening with my new job I totally forgot! So now I'm on the hunt for another office, or maybe none at all. I had been going to that office since I was 1st diagnosed with depression/bipolar when I was 14! Because of not having insurance I quit going for so long and then I went to a different location recommended by the inpatient facility I stayed at, and now I try to go back and I miss 1 appointment and the drop me! After over 10 years?! I don't know where to turn now. My primary Dr can fill my Xanax prescription, but I want to get back on my bipolar meds. Yeah I could go to the other place, but what if they do the same thing? Plus their from desk is rude. I really felt comfortable at the other place, now I have to get use to something new.

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The letter might be a kind of form letter. I strongly suggest you call the office and explain that the 2 appointments were 3 years apart and if they accept you back as a patient, be sure that if you have to miss an appt., cancel it well in advance. P-docs are really sticky about missed appointments.

I did call and they told me there was absolutely nothing I could do. I wonder if there is someone I can write or talk to because it makes no sense. If I was going in as a "New Patient" after 3 years why is a appointment from that long ago being held against me?

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Seems really unfair to me. You can pursue the situation, really fight it, if you want to. I think a lot depends upon whether your p-doc is in private practice or if s/he is connected to a health insurance company. If it's private practice, s/he can pretty much make up his/her own rules, but if it's through an ins company you can contact a patient advocate.

I had something kind-of similar a couple years back. (IMO) I believe this is how shrinks get rid of the people they do not want to help. IE we are too difficult of a challenge for them.

Sorry.

Get past the office manager who is telling you this and speak directly with your pdoc about the situation. IF an exception is to be made, it will probably have to be made by him. If he won't make an exception, you are probably screwed.

sorry hang in there

Agree with sierra.

One of my pDocs sent a letter out that he was changing his practice and would only see "select patients". WTF? I never found out if I was "selected" because I didn't want to go back to someone who could send such a letter. He never contacted me either, so I guess it was a form letter, and I wasn't selected. No big loss. All he did was prescribe meds anyway.

yea people around here in the city are getting these same type of letters.. short version is that with the new obama care where more and more people are now insured (here in the USA its now the law that everyone has to have health insurance now (either private or medicaid or medicare or get fined). because of this mental health agencies are now seeing more people then ever due to more people have the insurance to get the care they need. so agencies can not wait for no shows to decide whether they want to keep coming or not. many agencies are now able to type in a person information and see how long its been since their last visit. Here where I work the cut off is 6 months... meaning if a person hass't been in to see their therapist or psychiatrist for the past 6 months they are dropped off the schedule which makes room for another patient that may be on the waiting list.

my suggestion is what I tell all our clients here at the crisis center....if you want to be seen at that agency that dropped you contact them and set up a new intake appointment and keep that appointment so that they can re add you to their list of active patients. then check in with them periodically even when you are doing good so that your place on their active record stays active. by checking in periodically you can also be informed of any new rules that agency is installing.

insurance coverage there is a federal website you can go to sign up for health care or you can contact your nearest welfare/medicaid/medicare office. they can help you get your insurance set up before you end up getting fined. here is the federal website...

https://www.healthcare.gov/

yes the enrollment time is over for the federal site for 2014 but you can still fill in info that can tell you if you are elligible for other insurance plans. and there is no time frame on going to your social services agency and applying for medicaid with is state medical insurance that goes according to your income level just like foodstamps and cash grants.

Not only is sending a letter to a patient terminating their treatment unprofessional but it's also medically unethical. A decent psychiatrist will discuss the termination process with the patient and assist the patient in preparing for the end of therapy. This should be done in person and not in letter form. If you really feel up to it, you can report the practice to the state's psychiatric board and report what has occurred. It definitely sounds unreasonable that they just dismissed you like a piss ant. Sad that you had to experience this.

Exactly! Especially since I knew nothing of the this policy until I got the certified letter. Usually you just pay the missed appointment fee and reschedule. In all the years of me going to that office I was never told I would be basically banned from receiving help by missing 2 appointments. Smh Idk quite yet if I want to take this further I may just find another office.

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A psychiatrist has an obligation to refer you to another provider if they are terminating treatment with you. They can't just leave you high and dry. It's unethical and in some cases can be a reason for malpratice.

Im sorry to disagree with you but here in the USA it is not....unethical or illegal to send a client (or employee for that matter) of any profession a termination letter.

it may not be ...morally....right in some peoples opinions ....but here in america we have rights such as we have the right to choose who we want for treatment providers and treatment providers have the right to treat someone or not.

we also have the freedom of speech where we as american's can put anything in written or verbal forms of expression.. that means if a treatment provider wants to write a letter to notify someone of changes to their treatment , their files, their accounts or termination they can do so.

there is no written in stone.... laws or ethics.... here in america saying an agency or treatment provider must meet with the client in person to have a termination/closure meeting.

in fact many agencies and treatment providers include forms with in their intake process where it states in the event that the agency needs to contact the person for any reason which mode of communication do you prefer....phone, email, postal, one on one meeting or a team meeting, all of the above. please circle your choices...

even billing can now be paperless (email/text) in person or by postal mail, here in america and this is not just for treatment providers. my bills are all set up for paperless/email and for my options of treatment providers needing to contact me I chose the options of landline(home phone)/cellphone/text/email/postal. my treatment provider usually sends me a text any time she needs to contact me because she knows I may not always be checking emails, or home to get the land line call and it sometimes takes time for postal mail to get to me but I always have my cell phone on me.

we live in a world where there are more options then ever for communication with those we have in our lives. once upon a time ago it was just by postal mail that people got notified of the news/changes/getting hired/getting fired/ being accepted for schooling or treatment providers.... then along came telephones and that added a new way of communication, then along came computers and cell phones...

there were many more discoveries for communication in between these but my point is here in america we have many options for how employers and treatment providers, friends and family can be communicating with others. and none are illegal, though some agencies set their own guidelines depending on what level of confidentiality they stand to...and in some cases which communication option the client has chosen.

An individual in the helping profession such as a psychiatrist or psychologist do receive training in the termination process with a client. If they didn't receive this training, then their training was lacking in proper protocol.

We're not discussing employers. other companies, friends, family members, etc. The topic was specifically about how a person's treatment was ended via form letter. A therapeutic alliance is hopefully established with a client and ending it in such a manner is outright unethical and morally irresponsible. Just because technology has evolved doesn't wipe out the proper way to handle delicate situations. Being a client of a psychiatrist most definitely falls into the "delicate" category. Not to mention the possible harm that could result by a so called professional handling a termination in this way.

I contacted the American psychiatric association this morning to verify I was not leading anyone astray on this issue. I asked them what are the legal and ethical ways in which clients and therapists are able to terminate treatment with each other....their reply.....

with in the USA the ways in which a client can legally and ethically terminate with a treatment provider are...

just never go back (the most popular way)
schedule a session to inform the treatment provider that they will not be back
send the treatment provider a letter informing them they will not be back
phone call informing the treatment provider that they will not be back
email the treatment provider informing them they will not be back
court action (this one applies if the client has been court mandated into treatment.)

with in the USA the ways that a treatment provider can legally and ethically terminate with a client in the USA is....

send a letter to the client informing them that they will not be on their caseload any longer and why
phone call to the client informing them that they will no longer be their treatment provider (if client does not answer or is not available by phone send a letter, do not leave a message due to confidentiality laws.)
email /text (this one is not highly endorsed due to lack of confidentiality but can be done if the client has a form on file stating they wish this mode of contact.)
confer with client about scheduling a closure session, if client is not open to this, use alternate mode of contact ie phone or written.

I realize that other countries may not have so many options for their clients and treatment providers and not everyone is going to agree to what is the best mode of contact between treatment providers and their clients. line in the sand is that here in america we have the freedom to do things in many different ways and there is no iron clad right or wrong...

as for training....well here in NY the training on how to terminate with a client is the instructor explaining there is no one right way, some clients will just up and walk out and never come back, others want the I need to say goodbye sessions, some want it in writing, some clients will want a phone call, above all put it in writing in a termination/closing the case letter so that the client may seek treatment elsewhere if they chose and it will also serve as official documentation that the case was closed and when.

each agency and treatment provider can choose which ever mode of termination/closing process they wish to use.

if anyone wishes to find out what the standards are for their own locations they can contact their locations ethics boards for clinical social workers/psychiatrists/psychologists.

Don't take it personally, my analyst dropped me also only he didn't tell me, I arrived for my usual appointment and the door was locked, he practiced from his home so I thought he might have been delayed somewhere and waited for 15 mins for him to come back, when he didn't I left and expect him to call me with an explanation, he never did, this was very bad as I started seeing him when my first analyst of 7 years died, they were brothers, and I had been seeing him for more than 7 years when he dropped me. It was 3 months after my father died and I think was really cold. Surely there must be a medical board where you can lodge a complaint. Or would you want to risk your happiness as these things always cause stress.

Sometimes that is how psychiatrists operate. The can pretty much do as they please. Its very poor behavior that they do not even ask why you missed your appointment.
Some times I feel myself that they [Psy's] live in their own world a mile away from ours.
Keep holding on as at the end of the day you have yourself alone to depend on.

Missing two appointments seems an overreactive termination policy. I'd been dropped a long time ago, psychiatry neurology therapy general practitioners pediatrician etc...life happens, mistakes get made..omg I'm sorry this is happening to you . ..are their offices just too overbooked? Are they elitist or something?

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calm, is this also true of psychologists? Mine opted out of medicare (my insurance) last year and should have been dropped from my plan but they only realized it last month, so they terminated her effective June 1, and she emailed me this morning to let me know and say sorry, if i want to continue with her it will cost $120 dollars per session (I go twice a week, and the insurance rate is $75, not $120). But I guess it doesnt matter bc I couldnt afford the $75 either even if she would accept it, and she wont.

Hi InRealLife45,

There are quite a few references on the internet relating to the termination process between therapist and client. In general, they all seem to adhere to the basic belief that the proper way for termination is done over a period of time and face-to-face. Your situation is unique.

From what I gather, your therapist opted out of Medicare, and you were left with the one insurance company coverage. What I'm confused about is why the other insurance company plan terminated her from their plan. When they did that they created a situation where your therapist needed to terminate your treatment. She did email you and offer to continue treatment. Unfortunately, you're unable to pay out of pocket which is totally understandable. I do think you have the right to speak with her and explain how you feel. Have you considered calling her? At least speaking with her might afford you some consolation about the ending of your therapy and how it went. You have nothing to lose by trying. Also, I'd contact your insurance company and express to them how their actions have caused a lot of trouble for you. Sorry this unfortunate set of circumstances happened to you. The insurance companies need to be closely regulated so they can't get away with doing this sort of thing to people. I wish you well with whatever follows.

ive been at this to long I always have a back up until I get a new shrink. if these crappy people act like that just find another first then don't bother going in. but, make sure you have a dr waiting in the wings.

did you call and say u werent going to show up to those appointments?