Yes, the topic is venturing into being off topic.   I'd like to add a few 
thoughts before letting this one go.

Just like in a "bad marriage" sometimes one needs a "divorce" from a family.  
 Yes, in my role as a physician to goal is to help families make good choices 
about their children's health.   Unfortunately in our very litigious 
environment in the US, I am to a certain extent liable for a parents poor choice.
I let my families know where I am at about "health care."   If we cannot meet 
each other at least halfway, its time to move on.   My office policy has been 
to remind families several times of my practice policy in person and by mail 
before discharging them.   I give them thirty days to find another provider 
(which is standard practice in California).

I have had parents be verbally abusive to me and staff.   I have had parents 
repeatedly no show for appointments (my threshold is three missed 
appointments- I don't get paid for missed appointments).  My most life changing case was a 
mother who had Munchausen by Proxy and a little boy with severe cerebral 
palsy.   My threatened to shoot me because of the care I delivered (as in 
requesting that she get nursing services at home, follow through on physical therapy 
and other care recommendations).   I had to get a restraining order as she knew 
also where I lived and where my son attended school.   I ended up having to 
take three months off from work because of the stress (without the benefit of 
disability), hire a locums.   I lost a third of my patient base, and am in 
major debt for the last two years because of it (I have to sell my house to clear 
the debt).   I have made a conscious choice to leave a community I have lived 
and worked in for 10 years as the restraining order ends this fall.

I don't do myself or my practice any good if I try to be all things to all 
people.   The superdoc cape has been retired.

Best,

Pierrette Mimi Poinsett MD


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