In our practice, if a patient has repeatedly (more than 3 times) ignored our office policies (i.e. not keeping necessary follow ups if we're prescribing meds that need to be monitored), then we write them a letter indicating that the doctor feels they have a medical condition that needs to be followed by a physician for their health & safety. We let them know that they've been either unable or unwilling to follow the doctors advice and that they need to find another physician to take care of them. We give them 90 days (RI Law) of continuous care (refill meds, see them if needed) but they need to find another doctor or have their PCP or another neurologist take over their treatment plan. Records accumulated by this office will be sent to a physician of their choice.
There is a massive shortage of neurologists in our area that aren't booking out 3-5 months. What we have no shortage of are people looking to feel better and be seen in a timely fashion. We don't want to waste our time, or the patient's for that matter, if they're not going to follow the advice given or the policies that are put in place for their protection.
Hope this answers your question.
