One of your patients has psychological problems and is very demanding. He makes frequent complaints about your practice that you go great lengths to address. Is there anything you can do?
You should discuss your concerns with the patient and, in light of his past medical history, explore any clinical or psychiatric causes for his behaviour.
Examples of unacceptable behaviour should be explained to the patient and boundaries can be set to allow him the opportunity to remediate his conduct. It would also be beneficial to explain what services he can reasonably expect from the practice.
The GMC states that doctors must not end a relationship with a patient solely because of a complaint. Occasionally, multiple or malicious complaints can lead to a breakdown in the doctor-patient relationship and removal from a list; however wherever possible more specific reasons should be given for removal from the list. These cannot relate to the patient's race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition,
If you decide to proceed with removal then the patient must be informed of the decision and the reasons for it, in writing. Patients should be given information about how to register with a new GP and the PCT must be informed. Your practice could be criticised if no written warning was given in the preceding twelve months.
Dr Jayne Molodynski is a medicolegal adviser at the Medical Protection Society
Dr Jayne Molodynski is a medicolegal adviser at the Medical Protection Society
