I think documentation is really important, and that is why I started doing the Informed Refusal as suggested by my insurance company. Regardless of the patient's decision, their families can and do sue doctors after grandma dies. It's pretty hard to argue with an Informed Refusal. Our community is really short on Medicare accepting doctors, so I think such a patient may need to move over for someone who wants to see a doctor, has Medicare, and will actually benefit from the care by following directions.
