Doctors Who Are Glad A Patient Stopped Seeing Them Reveal Why

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Doctors and nurses put up with a lot of crap from patients and some end up being too much to handle, or even abusive. For example, patients sometimes blame doctors if they miss appointments; or they don't want to wait for treatment to work, or they're simply rude to staff. Whatever the case, doctors are often happy to see some patients leave and never come back.

elwheeler99 asked, [Serious] Doctors and Therapists of Reddit, have you ever been glad that a patient stopped coming to you? What happened?

Submissions have been edited for clarity, context, and profanity.

No eating before surgery - this is universal.

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Orthopedic Surgeon here. Best (worst) patient shows up for elective surgery munching on a big cup of ice. Big nope. Tell her we have to reschedule her case. She throws a tantrum. "But I have dry mouth and have to chew this ice". I understand, but we can't put you under with a belly full of water (risk of throwing up and sucking all that stomach goo into your lungs and dying). Go back and forth like this for a few minutes. I say to her "You know, talking to you is like talking to a toddler". She didn't like that at all. Finally tell her to go home and I leave the preop area. A few minutes later the nurse finds me and says Ms. Pain in the Ass won't leave, she says she doesn't have a ride home. I give the nurse $20 to call her a cab. To this day still the best use of a twenty ever. Never heard from her again.

Doctors can lose their licenses for fooling around with patients.

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I had a patient that I saw quite often for a number of simple illnesses. She would often joke that she came in just because I was working the clinic that day, said she would check if my vehicle was outside. Over the course of several months, I noticed she was coming in more often and with less clothing on. Short skirts, low cut tops. Last straw was her coming in with a loose fitting shirt and no bra. I fired her as a patient after that.

What? It takes time to make stuff?

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Angry dude started ramming his head into the wall repeatedly, so hard that a bold receptionist walked into the room without knocking to check I wasn't the one being slammed into the wall. All of this occurred because he wasn't willing to accept a two week wait time for a completely custom medical device to be manufactured and shipped from another COUNTRY

From experience: some pain, like in the gut, is only alleviated by opioids.

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Yes, but almost exclusively patients that are seeking controlled substances that I don't believe are indicated for their condition. I've never fired a patient, but I've definitely had patients that don't appreciate my attempts to wean them off their chronic opioids. Many patients with chronic pain are happy to try my suggestions. However for those that aren't interested in reducing their dependence on these medications, I don't think I'm a great fit as their doctor.

Pharmacists aren't the fun type of drug dealers, sorry.

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I work in a pharmacy and get yelled at all the time by customers over pain meds- almost always public aid also. "What do you mean I can't have it early?!" (13 days too soon.) "Why won't my dr refill that?!"

Best one was a customer recently yelled at us for giving their dr a medication list, She told me on the phone "I'm trying to get something stronger than Tylenol 3. Don't tell my dr what I'm on!!" Yeah, good luck.

Being pinned by an non-medicated patient with schizophrenia...who thinks the appointment is a date...with no panic button...or exit...

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I used to manage clinical trials for some bigger name of the last trials I managed required working with folks with schizophrenia who were not on medication. To be fair, this story is NOT typical of those folks, and I don't want to stereotype them, but I'm just saying this to explain the behavior in this instance. The study involved 3-4 visits totaling 10-12 hours with these folks, so I got to know them fairly well. My portion involved an extensive clinical/diagnostic assessment and some other computerized tasks, so all told I spent 4ish hours alone with them (the rest was taking them to other providers/appts for the study). This all occurred in a room that (A) didn't have a panic alarm and (B) where I was not closest to the door, which are two big no-nos. I did bring it up when I first started but was younger, naive, and figured the odds of something happening in this context was low.

I worked with upwards of 120 people and heard all kinds of stuff, like a little old lady who described her vivid hallucinations of people being cut up into pieces, slaughtering others, etc. just as calmly as she talked about her love of scrapbooking. None of this stuff ever bothered me, largely because even when people describe stuff like that there are so many other indicators to tell you whether or not they're dangerous, and most of the time they're not. Several others were pretty terrified of the other portions of the study (not disclosing, but people without schizophrenia were afraid of it, so it was normal) but were so compelled to help our research so others wouldn't have to feel the way they felt that it was inspiring.

Then I had one who was incredibly obsessive. I didn't spend enough time with her to figure out if this was separate from or a part of her schizophrenia, but she ended up pinning me in the corner, grilling me in an aggressive-but-crying manner about why I kept asking her to come back to these appointments but didn't want to date her (she had NEVER mentioned this until this point). Again, no panic buttons, no way out. I'm a small guy and she was taller and much larger than me. Thankfully her mom came to pick her up a little early and it saved my ass. But it happened in a matter of a minute or less and that's what scared me most.

Suffice to say I told my supervisor I would NOT be continuing that study until he rearranged the clinic so I was closest to the door and we had a panic button/protocol in place.

People who want opinion after opinion but won't take advice..

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In my homeland, I used to run an outpatient clinic together with several other GPs. The patients can freely choose which doctor they want to visit, or if they're regular patients, to change doctor if they want. Somehow, I was always stuck with annoying patients, like those who were overdemanding, tried to steer the doctors on what to examine and what to prescribe, impossibly uncooperative or non-compliant, hardheaded and in complete denial, like to argue back, all you can name it. Most of them are also doctor shoppers and like to boast about that - a clear red flag.

Usually, most doctors would try to be sugary sweet and nice and suck up to these patients no matter what, but I just couldn't - I treated them like any other patients - yes means yes and no means no, we can discuss the medications and course of examinations but you can't steer me around like a car and have it all your way as you please.

Most of these difficult patients were often displeased and somewhat crossed by my policy - yet they keep returning to me, despite me giving very clear sign I'm never going to treat them specially or give in to their demand. Eventually, after several consultations, a lot of them would never return (which was completely expected from their doctor shopping behavior). I always feel a lot relieved while wondering why they didn't go away sooner. Even my colleagues and nurses often joked whenever a new difficult patient came, saying my calling had come.???????

It's almost as if a doctor's time is valuable.

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Just a recent one that popped into mind. Had a lady in her 40's come in the other day who had an extensive and complex medical history and some psychiatric illnesses. She showed up 15 minutes late so by the time I brought her in the next patient whos turn it was already there. She had a list of about 6 things she wanted to go over. We got through a few of the issues and then mainly focussed on her issue with some pain while peeing on and off for 6 months, and she wanted antibiotics for it. She refused to supply a urine sample or undergo an STI screen.

About 2 weeks later I got a note from the nurse that the lady wanted to lay a "big complaint" about me because I didn't 'check her blood pressure.'

Like holy sh_t, you have 6 things you want to get through in your 15 minutes, you show up late (and so I could have declined to see her and just asked her to reschedule) and now you are angry at me for not doing something that would take more time and wasn't even relevant to the consult. So happy she never came back.

As George Carlin said, "pricks live forever."

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I used to practice in a clinical situation where most of my patients were older or elderly. It didn't happen often, but the patients that I would always dread seeing were the ones who were starting to lose cognitive skills and memory abilities but had absolutely nobody else I was legally authorized to speak about their care with (spouse was deceased, no kids or kids were estranged, etc.). Appointments could often turn into he-said-she-said, so it would take me forever to write reports for those patients because I essentially had to include every word said by either of us into the report to document that I told them something... for when they inevitably returned, later on, complaining that I never told them that exact thing. I'd never wish anyone harm, but I did occasionally find myself searching local obituaries when I'd realize I hadn't seen certain patients like that in a while, in the hopes that maybe I wouldn't have to. (Pro tip: The mean ones never die.)

When your patients bore you to death...

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Totally mundane anecdote - had a person who insisted on regular contact (no cost to them they received general support from our service but wanted a regular appointment with a psychologist) that didn't really have a purpose other than a general chat, basically just encouraged spacing out appointments and then at some point they just decided they couldn't be bothered walking in. It's kind of surprising how draining it is to have a benign but knowingly un-useful appointment on the regular

Brace for a plot twist...

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A couple of years after becoming an attending surgeon, I had this miserably pessimistic patient with problems mostly related to self-neglect. She was agoraphobic, barely left her house, and a glutton for misery, basically refusing to do anything that might better her circumstance. She came to see me because she had a gastric bypass somewhere else in the past and wanted continuity of care.

One day she hands me an envelope and tells me I've been served and that she's sorry her husband the process server couldn't ever catch me at home because I work too much. It's true, I was working quite a lot because my wife of 12 years was being insufferable since we had moved away from her best friend in Miami for an incredibly better quality of life and work situation.

Anyways, they were divorce papers and my wife was leaving me to marry her friend's brother which I was already anticipating. It worked out well because then I was free to start over fresh with someone who shared my current priorities. Now we have 3 kids and a great life of rewarding work for only half-days, frequent travel and leisure, and three awesome young children. The miserable patient didn't feel comfortable having me as her provider after that even though I offered to continue to do so.

Huge win on all counts.

It's not the doctor's fault if you don't show up.

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Sure. Sometimes it's just not a good fit and that's a relief. The one I recall the most relief around worked hard to blame me for her lack of attendance and no-shows, going as far as to scream at me on the phone and accuse me of lying after I had been crystal clear regarding my boundaries and attendance expectations. She was not ready for therapy in the way I was able to provide it. She came back to the clinic later and saw someone else and did a lot better. I felt for her, but I'm not putting up with that.

Good things won't happen if you bad mouth coworkers to each other.

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Neither a doctor or therapist, but I'm a manager at Laser Hair Removal Clinic which also does chemical peels.

We had this one client who we will call Dumb B** (DB).

So she would come to use for treatment for laser, and go to one of our therapists. Now typically our clients will always see the same therapist for consistency, but this time we couldnt. After the treatment, she complimented our therapist and then when our therapist left, DB said to our receptionist that she was terrible and wants to see someone else.. Okay cool so we booked her in with the next therapist and during her treatment, she just starts b**ing about her previous one. Comes out and compliments our therapist, then asks to see a different one - like what???

She then starts b*ing to the next therapist about the previous two. She did the same pattern through all 5 of our therapists and then goes back to her original and b*es about the other therapists and says "You're the only one I like, the others are just horrible and you're the nice one."

Now she said some very racist and harsh remarks during her YELLING, so I had to talk to her about it and tell her that we cannot treat her anymore.

When the shrink can't handle the patient's trauma... my curiosity is peaking.

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Friend of my parents who is a therapist told me this story when I asked her about how she coped with her patients' suffering. She told me that there was one patient she had and wished she would never have met, through no fault of his own, though. She wouldn't give me much detail of course, but this is the gist of the story. She had a patient who came to counseling after decades of trying to cope with his childhood on his own and failing. It took quite some time for him to finally be able to tell her how he had been terribly abused as a kid. He proceeded to tell her about all the horrific things that had been done to him. It was absolutely terrifying and heart-breaking that anyone could go through this and according to my parent's friend it was surprising he even could survive. The horrors the patient described made a lasting impression on his therapist and started messing with her badly for some reason. She was not used to treating trauma of this kind and it came to a point when she would be reluctant meeting her patient because she knew he would talk about things that frightened her. She didn't want to break his trust, though, and he really needed the therapy, so she said nothing. After a while, however, the patient noticed that he was unwillingly making her uncomfortable and mentioned it in a session. They both agreed that she couldn't help him in these conditions and it would be better if she referred him to a colleague. She told me she was quite relieved not having to deal with this patient anymore but at the same time felt inadequate and unprofessional for being frightened by his pain.

Managing expectations with doctors is difficult, especially when you're in pain.

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Unrealistic expectations. Expectation management is a real thing and I have had patients come to me demanding the guaranteed investigation/procedure that will solve their problems that they were promised earlier in their referral pathway or from some internet forum (!). Usually, education with relevant facts clear things up but it eats into the next patients waiting time and that is one reason why clinics overrun. I remember being particularly relieved but felt sorry for a patient who kept coming back with "alternative" treatments for his very curable cancer despite attempts to educate and support him on the merits of modern medicine. Eventually, he went elsewhere presumably to try and find someone who would give him the answers he wanted to hear.

Watch out for the black bathwater...

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I did peer support and residential support specialist stuff so not a therapist or anything. But I had one client who was severely symptomatic. Heard voices a lot and would argue loudly with them. Would hurt themselves for attention. Had awful boundary issues with other clients that was borderline stalking. Was reprimanded multiple times for bouts of harassment towards other clients. Didn't like to shower and believed that when bathwater turned black it was toxins leaving your body and not just because they were that dirty. I truly hope this person found the help they needed and the right therapy though.

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