Why Discharging Patients Against Medical Advice Sucks

[@montanagal6958]

During Covid, patients were literally forced into isolation and given experimental drugs without informed choice made to die alone. I tell people if you feel unsafe or that the hospital is trying to hurt you, leave AMA. (nurse).

[@HachikoTanuki]

Very interesting content, thank you for sharing your research and insight!

[@loricates468]

As a nurse, the paperwork protects more than yourself. Not all customers are willing to wait until a discussion can take place. Forcing people to stay could be concidered illegal restraint.

[@ConanLiuMD]

Yes, patients may leave if they want to. No need to fill out paperwork though as there hasn’t been any evidence that it protects anyone, just document that patient eloped

[@ktg787]

I will be interested to see in real practice how a discussion with a patient using this approach looks like.

[@josephineria9208]

Lack of education and communication can result in patient leaving not even knowing they leave AMA. I just recently saw a patient leaving the hospital without getting proper instructions just to get readmit later on and turned out he had no idea about the proper discharge process in the first place!

[@sunitapillai1820]

I do patient directed discharge

[@mikeiilo]

Are their special steps that need to be done in Epic when discharging an AMA patient ?

[@ConanLiuMD]

No - you do it as a normal discharge but in the discharge summary you generally document that you discussed the risks/benefits of leaving with the patient and they expressed understanding/had capacity to leave.

[@mikeiilo]

Thanks for the reply @@ConanLiuMD

[@gymrat3203]

Interesting video and I agree with you on many points. You implied that you're the judge on if the reason is valid to leave. If I want to leave it is my choice and I owe you nothing, my body my choice. I am an insured white male who detest hospitals and would have to be at death's door or bleeding out to even stay. My family knows and respects my wishes. I wasn't always that way. Doctors taught me to distrust them with their deceptiveness. Get bitten over and over again by a dog and you end up being wary of dogs....doctors are no different.

[@kjstclair5121]

We waited 20 hours for a referral to another Dr. -nothing immediate/urgent-the Dr. where we were had already told us he couldn’t do the surgery, but he went home instead of getting us a referral and discharge. So we left, now insurance is denying payment for the day we left- no paperwork-. they took out the IV and walked us to the door. We felt like we were being held hostage. This is absurd to me we may have to pay. Something about the hospital contract states they can’t bill us (the insurance I’m guessing although it lists my child’s name).

[@GatorAidMedical]

A good thought experiment (and bear with me here, it's a stretch) is pretending you time traveled back to the 1800s. Let's say you know you have cellulitis from going into some rose thorns without pants on. The treatment suggested by my town healer (no medical school) is to suck blood out of me with leeches and recommend prayer. I refuse and leave AMA. As a doctor in the 1800s, should I be upset at them for not listening to me? Clearly there are many fallacies here but I find it a good thought.

[@ConanLiuMD]

I love that thought! It’s so true. We think we know the best treatments for everything today, but who knows in just a few years or decades we will be laughing at the way we used to manage these diseases. And then maybe the patients who left AMA were right all along!

[@michalchrusciel198]

i was in the hospital for knee surgery which my knee felt great i felt i didnt need surgery so they day before surgery i said screw it i just got up and left and never contacted dr again

[@GatorAidMedical]

I always wondered about point #1

[@anonymousdoe3755]

If your in nj ill be your new patient. Thank you for saying the truth

[@fsufan]

I just did an AMA discharge 3 days ago. I was told at 8AM I would be discharge that day. At 3PM I still wasn't discharge and it looked like it would be another 2-3 hours. I walked out. a discharge shouldn't take 7+ hours

[@ConanLiuMD]

Agreed - even if we feel it’s in a patients best interest to stay, there are many valid reasons they have to leave and it shouldn’t feel like we are forcing people to stay against their wishes!

[@kritika91]

This guys a resident ?

[@brumleytown1882]

Regardless of this fine video, it is disconcerting that it took making this video to convince yourself. Go back to the hospital and start talking to your doctor companions, not us.

[@ConanLiuMD]

These videos are mainly made for people working in the hospital 😊

[@cpippin0525]

Surgeon says he cannot care for me anymore. WBC increasing, 2 new bacterial infections in my blood. Accepting hospital taking too long with transfer. Can I leave AMA and go to ER of Accepting hospital to speed up the process? ​@ConanLiuMD