I have a mother of an attending physician who is residing in Assisted Living. She is on two Class 2 drugs (amphetamines and oxycodone) for pain and energy issues. I expect a visit every three months, however, the assisted living refuses to transport the patient to my clinic. They state that her son (the doctor) don't think it is necessary. What gets me is that some of these nursing assistants start making medical decisions and will try to pester me into prescribing something or ordering tests (I'd say its a form of coersion).
I don't want to alienate the son (who has some influence over hospital administration and potentially privileging issues). I really do not know if he is the one that is objecting to evaluation (or the nursing assistant at the assisted living is making up the objections). We have in the past found out that the assisted living facility staff has tried splitting between the son and I.
They constantly call with issues and when I ask them to have the patient brought to my office, they state she doesn't need to be seen. Has anyone fired a patient due to facilities not cooperating? (The patient is OK).
This lack of control over directing patient care (with NH and ALF and family) has given me cold feet about accepting patients who don't have independent decision making skills.
