I am aware that for medicaid and its MCO's, patients have a right to change physicians anytime they want without any penalty to them. Infact, I have seen cases whereby patients are seen in one doctors office and they immediately leave to see another doctor same day because they were dissatisfied with something. However, insurance company's usually deny the first doctor's visit. In the same way, a doctor has a right to drop a patient from his panel provided he informs both the patient and the insurance company in writing while giving the patient 30 days to find another doctor. Without the 30 days notice, it amounts to abandonment of the patient and the physician is liable.

I agree with Edith and we have had numerous occasions in the hospital when patient does not like their physician and have asked and recieved another physician. This is most common in the hospitalist program where they do not have a long term relationship with the physician. We usually handle this by having his or her associate see the patient or call her primary physician to see. Please let me know if you need any other information

I agee with both Paula and Edith with relationship to physicians. Physicians are required to give in writing 30 day notice to patients where a physicians-patient relationship has been established. Where this gets gray is when a physician is consulted in the ER and the physician doesn't come in to see the atient and tells the ER doctor to send the patient to his/her office. Is there a physician-patient relationship established via a phone call from another doc?
I would also say that a patient has every right to request a different nurse, tech or any other ancillary provider while in the hospital and that wish should be honored. A patient may feel for some of the reasons mentioned above that it is in their best interest to request the change.
joanie.jeannette@verizon.net

Q1: My research for the state of Kansas echoes the responses stated above. Since our facility is rural and somewhat limited with our resources our medical staff some years ago adopted a policy to maintain the wishes of our patients. Even if this meant the patient had to be transferred. The intent is to work w/ the patient with a provider s/he has confidence in.
Q2: The receiving provider would first of all need to have the skill sets required and accept the patient.
Q3: The only initial exception I can imagine would be the necessary skill set the provider would need to handle immediate or emergent care until a suitable provider can be secured or the patient gets transferred to a facility that meets the expectation of the patient and/or family.

Here in Washington state the same is true. Patients have the right to "fire" a physician and hire a new one whenever they please. The challenging part is the reverse. It is more difficult for the physician to "fire" the patient.

A patient has a right to choose his/her care whether the insurance will be financially responsible or not. If the payor will not cover the change, then, the patient is responsible for the payment. This information should be given to all patients in the Patient Rights and Responsibilities.

This is usually a hospital policy and also addressed in bylaws but certainly has to be compliant with patients rights.

I agree with all stated above. I as a consumer of healthcare want to know that I have the right to change doctor if I feel my needs are not being met. The same is true when we flip the coin. As healthcare providers we are the patient advocate and if they wish/desire a change then it is our obligation to help this to occur. Most of the time this is seen with the hospitalist taking care of them and the change can be seamless, but other times the patient can be frustrated by their physician and what they view as lack of care.

The same goes for the Nurse, NA etc. caring for the patient. The patient should feel that they can express concern, need for change if the feel, perceive their health care provider is not meeting their needs. This can often be hard for a patient and/or their family as they fear retribution.
Recently I was the patient and I know that every one of my providers feared caring for me because of the "who I am" in the institution. What about the other question does the healthcare provider nurse, NA etc. have the right to refuse to care for the patient?

What is the providers moral, ethical and professional obligation to honor the request or remove themselves and request reassignment?

They should remove themselves and if not have the right to contact the patient advocte this is in the patients bill of rights.

Does a patient have the right to change providers for any reason?

Yes

Does the type of provider change the right or circumstance under which a change in provider should be honored?

DOn't understand this one

Are there situations or events that would be exceptions to assigning a different provider?

Not if the patient choses to do so.

I am interested in entertaining how other HCO have handled these request. Our ethics committee is currently discussing this issue and we have found that there are varied and in some instances extreme differences in opinion.

I have encountered both patients requests, provider requests and all have been honored. Have only one time had to get involved with medical staff due to provider unwillingness to hand off. Care needs to be handed off provider to provider, Bylaws usually speak to this as does hospital policy.