I'm not necessarily really taking about the patients who leave in a huff.
Rather, I am talking about the (parents) who come in with a chip on their shoulder, look and act like they are sucking on lemons, and treat the staff as if they are slaves. It's not quite bad enough to discharge them from the practice, but it IS enough that I would not consider taking them back. That would include the parents who let their children run wild in the office.
I would agree that most patients don't tell you why they leave, you just get a release. We always release - once. If we receive a second request from a different provider, we send a letter back stating the records were previously released and we do not send a second copy without payment. The only exception is those who are out of town.