Dr. Joey Giordani says he has had a rude awakening to his first family practice – one he simply will not tolerate.
Following graduation from family medicine residency at Dalhousie University, Giordani took over Dr. Henk Visser’s Crapaud practice in early July.
Giordani felt eager, willing and able to take on a roughly 2,000-patient private family practice as a fee-for-service physician.
What he did not anticipate was just how abysmally some of those patients would behave.
They have cursed, yelled, threatened and demanded — time and again.
His front-desk staff, much more so than him, has been on the receiving end of a flurry of disrespectful comments.
“People will call in and they will demand and if they don’t get what they demand they yell, they scream, they swear, they accuse, they belittle,’’ says Giordani.
“I have sat by the office staff that are on the phone and I’ve heard the yelling, the screaming, the F-bombs personally with my own ears.’’
His first response was to send out warning letters informing people their behaviour was not acceptable and would not be tolerated.
Just one month into his practice, he even took the dramatic action of posting at the front desk a strongly worded warning to patients.
He stated in the note that he was “shocked and disappointed’’ to need to post the sign.
“Anyone rude, yelling, disrespectful or verbally abusive to my staff will be asked to leave my clinic,’’ he wrote in the post.
“If this behaviour becomes a regular occurrence you will be dismissed from the practice.’’
Still, the problem persisted.
The abuse kept coming.
So roughly two weeks ago, Giordani reached the “difficult decision’’ to downsize his practice by between 250 to 500 people to be more in line with what he deems the national average.
He told The Guardian during a lengthy interview Wednesday, his initial intent was to keep the continuity of care going for all of the approximately 2,000 active patients he took on after purchasing Visser’s practice.
He quickly realized the situation, due to a loud, unsettling minority of patients (he says 95 per cent are “wonderful’’), was not tenable.
“It got really ugly fast and it wasn’t ugly because I was working 14-hour days,’’ he says.
“It was ugly because of the behaviour of hundreds of people.’’
He says the logical solution may seem to be simply telling the patients who are being belligerent and unreasonable to shape up or find another doctor.
However, he says that would open him to legal action.
“So if you downsize your practice based on a belligerent person and that belligerent person has mental health issues, then you are discriminating against the mental health,’’ he says.
“So all of a sudden you are the bad guy and you are targeted legally.’’
So, instead, patients are now being randomly selected from electronic medical records to be removed from Giordani’s practice.
They will be given a 60-day grace period to get their medication scripts up to date and address any issues that may be delayed in the process of going from one physician to another.
Patients who are randomly cut from Dr. Joey Giordani’s practice are urged to contact the patient registry office to help ensure they are matched with another primary care provider. They can contact the patient registry office toll-free at 1-855-563-2101 or complete the application form online at www.healthpei.ca/patientregistry.
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Dr. Andre Celliers, chief of family and community medicine with the province, says the doctor’s decision to trim the number patients is disappointing.
He notes Health P.E.I. has met with Giordani on several occasions, offering support and to work with him.
“More recently, he has been referring some of his patients to Health P.E.I. so that we can work with them to better manage their chronic disease such as diabetes,’’ adds Celliers.
“It is unfortunate that he has decided to reduce his practice. As a fee-for-service physician, he is within his right to do so.’’
Leigh Craig, 72, of Hampton appears sympathetic to the plight of his new doctor, Giordani, who he describes as an “excellent’’ family physician.
“As long as he can keep up his good practice and look after the patients without getting overloaded,”says Craig.
Giordani is determined to do all in his power to make a success of the family practice in Crapaud.
The native of Pearl Harbour, N.S., has long held a strong affection for P.E.I., a place he has visited in the summer for decades.
So he purchased the Crapaud practice, bought a home in Bonshaw and moved to P.E.I. with the hope of finding a warm, safe and welcoming place to raise the family.
His wife, Naomi, has her hands full with four young children, ages one to eight, not to mention being the “everything lady” at his practice.
“She manages the office, she does blood draws, she does lab runs, organizes mail, works the front desk, cleans, orders lab material,” he says.
“I mean, you name it, she does it. She keeps me grounded.’’
Giordani also stresses he is not looking to slack off, even if he ends up cutting hundreds of patients from his practice.
Currently, he sees patients for 36 hours per week and does another 40-plus hours of paper work. His office hours are 7 a.m. to 7 p.m. three days a week, but he still works six days a week.
“I don’t mind hard work,’’ he says. “I’ve always been a hard worker.’’
Giordani is addressing the unacceptable abuse head-on in order to mold a sustainable career. He wants his patients to feel secure, to feel confident he is going to be there for them at the end of the day.
“And if things keep going the way they are going, I can’t guarantee that,’’ he says.
“I’m trying to fix the problems now so the relationship is sustainable for the next 20 or 30 years. I don’t want to pack up and go. I want to make a life here…We don’t want to go anywhere.’’