Czech Medical Chamber wants doctors to have greater freedom when it comes to problem patients

Anyone wishing to change doctors in the Czech Republic can do so with relative ease; the opposite, however, is not true for doctors. Doctors with ‘problem’ patients, who routinely ignore therapy or display obvious mistrust, are stuck. The Czech Medical Chamber wants that changed: for medical professionals to be able to refuse patients who refuse to help themselves.

Milan Kubek, photo: Marián Vojtek

Once registered at a general practitioner’s or even a specialist’s, a patient cannot be turned away, not even in cases where trust between doctor and patient has evaporated, where patients, for example, ignore doctor’s orders and fail to take medication or are openly critical or hostile. The Czech Medical Chamber wants doctors to have a greater say about the patients they treat, not least when patients fail to heed advice or take their medicine. Milan Kubek is the head of the Czech Medical Chamber:

“If a patient fails to respect a doctor’s recommendations, or repeatedly criticises the doctor, it is clear that there is no mutual trust. In such cases, doctors should be able to say [enough is enough] and that they won’t treat the person any longer.”

Cases where patients fail to respect doctors’ advice are probably common enough. One doctor told Czech TV, are critical, for example complaining the health professional had done nothing to lower their blood pressure but at the same time admitting they had not taken the allotted meds. In such cases, doctors can find themselves at a loss. In theory, patients can be turned away even now, but only in the most extreme cases where it has been proven they blatantly refused to follow instructions. That can be difficult to prove. The new proposal should make matters more flexible but some guarantees also need to be provided, says Lenka Teska Arnoštová, the spokeswoman for the Health Ministry.

Photo: Khalil Baalbaki

“The ministry agrees with the proposal but only as long there is no negative impact on the patient’s state of health.”

Others have come out firmly against, saying the proposal would grant doctors “too much”. Patients’ Association president Luboš Olejar:

“We will be vassals who have to listen and can’t say a thing. Doctors will again be treated like gods.”

If the proposal is accepted, this much at least is certain: insurance companies will still be bound to find a different doctor for the ‘difficult’ patient.