Tom,
I agree 100%. We absolutely should not be making decisions on whether to terminate with patients based upon fears of government reprisal.
I think it is critical to look at the relationship we have with our patient. There is a reason they are coming. We may not understand that reason. The doctor patient-relationship is the foundation of patient care not whether or not our patients comply. In fact, I would say that trying to understand the barriers to adherence and maintaining an empathetic stance is at the core of what defines our role as healers--and makes our job more interesting.
Vaccine issues aside, so what if a patient a patient with diabetes is not following a diabetic diet--risking their health and making our job harder. That same patient may later develop cancer and we may be the only doctor they trust us to help him or her during a life threatening illness. Sure there are rare times to terminate with a patient but usually not for non-compliance alone. I thought paternalism was out of vogue.
I know I am a psychiatrist but I firmly believe that the best thing we can do for our patients is to listen to them.
