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Sometimes Long-term Patient/Healthcare Provider Relationship Must Be Severed

Feb 2, 2021

I am a primary care provider in a small private office. A long-term patient of mine, 32 years of age, was recently diagnosed with type 1 diabetes. His insurance is now one I do not participate in. Until his recent diagnosis, he visited annually and paid out of pocket.  He wanted to stay with me for his care. I realized his needs were most likely more than he could afford. He would need to privately pay for my services, which would now be more frequent, his medications would be expensive, and he would need more of a multidisciplinary team to meet his needs. Although difficult for both of us, I had a long discussion with him about the need to find a different health care team that accepted his plan. I helped him find this team and referred him on. This can divert disasters such as poorly managed diabetes and the complications that can arise from this. 

Lessons Learned: 


  • Long-term patient/healthcare professional relationships can feel like friend/family relationships. 
  • The healthcare provider must always keep the patients present healthcare needs above the long-term relationships. 
  • When a long-term patient has health changes or coverage changes, be open, be honest, inform the patient of the need for increased services for the long term, what that could entail and what that could cost. Offer and encourage to refer on to another healthcare provider who can best meet the patients needs. 



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