When Claudia Siegel got a stomach bug earlier this year, she reached out to her primary care doctor to prescribe something to relieve her diarrhea. The Philadelphia resident was surprised when she received an online message informing her that because she hadn\u2019t visited her doctor in more than three years, she was no longer a patient.<\/p>\n

And since he wasn\u2019t accepting new patients, she would have to find a new primary care physician.<\/p>\n

\u201cI think it\u2019s unconscionable,\u201d Siegel said, noting that many patients may have stayed away from the doctor\u2019s office the past few years because of the covid pandemic. \u201cThere was no notification to patients that they\u2019re on the verge of losing their doctor.\u201d<\/p>\n

Though it is dismaying to learn you\u2019ve been dropped from a physician\u2019s practice because a few years have passed since your last visit, the approach isn\u2019t uncommon. Exactly how widespread the experience is, no one can say. But specialists also do this.<\/p>\n

The argument for dropping the occasional patient makes some sense. Since many primary care doctors have a waiting list of prospective patients, removing those they rarely see opens up patient slots and improves access for others.<\/p>\n

\u201cMost primary care practices are incredibly busy, in part due to pent-up demand due to covid,\u201d said Dr. Russell Phillips<\/a>, director of Harvard Medical School\u2019s Center for Primary Care and a general internist at Beth Israel Deaconess Medical Center.<\/p>\n

\u201cEven though continuity of care is important, if the patient hasn\u2019t been in and we don\u2019t know if they\u2019re going to come in, it\u2019s hard to leave space for them,\u201d he said.<\/p>\n

Patients often move away or find a different doctor when their insurance changes without notifying the practice, experts say. In addition, physicians may seek to classify people they haven\u2019t seen in a long time as new patients since their medical, family, and social history may require a time-consuming update after a lengthy break. Patient status is one element that determines how much doctors get paid.<\/p>\n

Still, the transition can be trying for patients.<\/p>\n

\u201cI can completely understand the patient\u2019s perspective,\u201d said Courtney Jones, a senior director of case management at the Patient Advocate Foundation. \u201cYou believe you have a medical team that you\u2019ve trusted previously to help you make decisions, and now you have to find another trusted team.\u201d<\/p>\n

Siegel said she rarely went to the doctor, adhering to her physician father\u2019s counsel that people shouldn\u2019t go unless they\u2019re sick. Although she hadn\u2019t been to her doctor\u2019s office in person recently, Siegel said she had corresponded with the practice staff, including keeping them up to date on her covid vaccination status.<\/p>\n

After receiving the online dismissal through the patient portal for the Jefferson Health system, Siegel called the family medicine practice\u2019s patient line directly. They told her three years was the protocol and they had to follow it.<\/p>\n

\u201cI asked, \u2018What about the patient?\u2019\u201d Siegel said. \u201cThey didn\u2019t have an answer for that.\u201d<\/p>\n

It was a month before Siegel, who has coverage under Medicare\u2019s traditional fee-for-service program, could see a doctor who was accepting new patients. By that time, her stomach virus symptoms had resolved.<\/p>\n

Jefferson Health doesn\u2019t have a policy that patients lose their doctor if they\u2019re not seen regularly, according to a statement from spokesperson Damien Woods.<\/p>\n

However, he said, \u201cPatients not seen by their provider for three years or more are classified in the electronic medical records as new patients (rather than established patients), per Center for Medicare and Medicaid Services (CMS) guidance. Whenever possible, Jefferson works with these patients to keep them with their primary care provider and offers options for new providers in certain circumstances.\u201d<\/p>\n

American Medical Association ethics guidelines<\/a> recommend that physicians notify patients in advance when they\u2019re withdrawing from a case so they have time to find another physician.<\/p>\n