It is a sad fact that health care providers these days must have "best practices" they must follow, the health care corporation dictates that they must have their diabetic patients under certain control, those with high cholesterol must get their #'s down, etc. At the HMO I worked at, we were given benchmarks to meet and part of our pay was docked if not. So was it my fault my patients chose to continue to be morbidly obese? No, I can't really change their lifetime of bad habits or the fact they have bad genetics. It was a nightmare to inherit another train wreck. Some practitioners resort to doing what yours did in order to make it look as if they had their patients well managed. This is part of the burn out issue you keep hearing about. I've had plenty of patients who either couldn't tolerate statins or didn't work, if they simply didn't want to take them it was my job to explain the benefits and consequence of not doing it. I would never discharge a patient though. If they were blatantly non-compliant, I would mark that on their chart on multiple occasions to protect myself. In your case, I would have written that you have hypercholesteremia that did not respond well to statins and were non-tolerated. To discharge you from his practice is just wrong in my opinion. Unethical? Hard to say.
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