Let go. Fall Through Cracks. Hit Bottom.

And what about a “safety net?”

One learns early in taking care of sick people that a variety of circumstances can force (or allow) us to “let go” of a patient, often through the patient’s own failure to comply or participate. Sometimes the provider just does not possess the requisite skills. We cannot be all things to all patients.

I have operated on the theory that when I let a patient fall through the cracks the patient may find another physician better able to care for them. I believe that when some fall far enough they “hit bottom” and make a decision to take responsibility for the problem. Providing a “safety net” for all might prevent such a growing experience even while saving a some.

It seems that physicians employed by hospitals and other large organizations will find it difficult or impossible to “let go” of patients who might fall through the cracks of a private practice model. How can physicians working for large organizations avoid enabling patients to persist in self-defeating behaviors?

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