pone

The first article is an instruction sheet for the DOCTOR about how to leave the patient! Nothing about the reverse process is described. The second article is for US citizens, not Canadians.

I think all diplomacy was tried and exhausted and now the doctor's only function on the case is to act destructively and to impede the efforts of other doctors. The fact that he is a gatekeeper is exactly the reason they want him fired from their case, so that he can be prohibited explicitly from acting as a gatekeeper again.

Doesn't this article actually beg the question? The punchline here says "You can try to find another physician, at which point your enrolment with the previous one will end automatically. However, Ontario's Health Ministry encourages patients to end one relationship before starting another." Ironically, the article never tells you how to "end one relationship"!!! So, asking my original question in the language of your article, in Canada what is the formal process to end a relationship with a doctor? And does that process only apply to the main general practitioner?

The idea to use Mayo is a good one but I sense my friend can barely afford to pay for some out of pocket testing. Mayo's tests could run up a $20K USD bill just for testing alone in a short period of time. Your post confuses me because you said at the start of paragraph #2 "...I don't think any health region will refer you there and pay the bill." Then the last sentence contradicts that and says "...every case I have seen that got to Mayo (including some referred and paid under our universal sick care system)...." I don't understand the structure of Canadian healthcare. Why are some of these cases never paid, and why are others fully paid? Is there anything she can do to get even a partial compensation? Is there any way to obtain a dollar-for-dollar tax credit against her Canadian income? I agree with the first part of your post that there may be problems trying to attack the doctor's treatment or credentials. That is why I want to find a way to fire him without attacking him.

@betsy some great ideas there, which I would summarize as: * Contact your member of provincial parliament for advice and possibly for direct intervention in the case * Contact patient advocacy groups for different rare diseases (and there will be many) * Contact the press, to put an uncomfortable spotlight on the doctor

This is happening in Ontario, a large population with many doctors. This is not a place to do a medical diagnosis. Don't second guess symptoms here, please. I am deliberately not including relevant facts to the case. There are three metabolic geneticists who feel she has a metabolic disorder, and one of those is a nationally recognized, Harvard-trained expert. Let's not second guess them, and let's not change the topic. The original question was how do you fire a doctor. They could want to fire him for any reason they choose to. They don't have to justify that reason to you, to me, or to anyone else. I disagree with your advice to be open and honest and explain why you want a second opinion because they did all that already. Their specialist is a jerk with a personality disorder. They want him fired. How do they get him fired? Does Canada give patients any choice at all if you have the doctor from hell?

The child has problems with lethargy (semi-comatose and difficult to wake from naps), failure to thrive, leg pains, persistent vomiting. The child has seen multiple metabolic geneticists, and most of those suspect a metabolic disorder, and the details probably do not matter here. The problem doctor is convinced the child does not have a metabolic disorder, and he sabotages all attempts by other doctors to order additional testing or to recommend diagnostic approaches. A typical interaction is that doctor A writes a letter suggesting possible metabolic diseases and testing protocols and sends to doctor B (the bad doctor). Doctor B tells the parents "I disagree with everything she says" and then fails to follow a single recommendation of A. So there are no belief systems involved in this case. But if there were belief systems it should be the right of a parent or patient to decide that a particular doctor will no longer participate in their case. There shouldn't be a need to justify that decision to anyone. P.S., who in their right mind would trust the institution of medicine? Anyone who has a difficult diagnosis and who has been trying to work within the system cannot help but conclude that medicine - as currently structured - hates human beings and treats most of us with utter contempt.

Maybe that has merit, but at best that results in a disciplinary action. That really isn't the desired outcome. She isn't trying to prove his incompetence. The desired outcome is to prohibit his further interference in her case. What they want is some kind of formal administrative ruling that removes him from the case so he can no longer block any action by a different doctor, and if he does intervene then he would be subject to disciplinary action in the future. I think they are totally okay with an outcome where no one questions his expertise but he simply is forced out of the picture. Is there any formal process to support that desired outcome?

I have a Canadian friend with a very sick child and a problem with a specific specialist. The specialist saw the child a few years ago and dismissed any diagnosis. Now the parents have other specialists who think the first specialist might be wrong who are requesting additional testing. In every case, the first specialist somehow learns about the activity of the other doctors. He then steps in and sabotages all of their efforts. He somehow intimidates the other doctors and they then back off the case. My friend wants the specialist fired. Not only does she want the specialist to not give an opinion to her, but she wants to forbid his participation in the child's case, and to strictly forbid his talking to any other doctors they go to. Does Canada have any administrative process to accomplish this? How is it done? Who should she speak with? How much bureaucracy and process is involved in getting a formal bureaucracy involved here to silence the troublemaker?