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EDITORIAL: Patients in turmoil

Dr. Joey Giordani says despite encountering a high level of unacceptable behaviour from some patients at his new family practice in Crapaud, he hopes to enjoy a sustainable office in the small community for years to come.
Dr. Joey Giordani says despite encountering a high level of unacceptable behaviour from some patients at his new family practice in Crapaud, he hopes to enjoy a sustainable office in the small community for years to come.

Efforts to reduce number of patients and problem patients causing angst

There is something almost biblical with the medical drama unfolding in the Crapaud area. A new doctor, replacing a revered, local physician, is encountering problems as he tries to establish a practice. They are caused, partly, by too many patients on the list he inherited, and that among that list, are a number of problem individuals.

Where the Bible’s parable indicated that a farmer allowed both wheat and weeds to grow together until harvest - when it was safe to separate the good from the bad - Dr. Joey Giordani is doing some early chaotic uprooting.

Dr. Giordani took over Dr. Henk Visser’s Crapaud practice in early July on a fee for service basis. It should be noted that before his retirement after 32 years, Dr. Visser set up a succession plan and for a number of months, worked with Dr. Giordani. There should have been no surprises on what lay ahead.

As a new doctor gets to know his or her patients, their history and medical needs, it takes extra time for each appointment. It soon became apparent to Dr. Giordani that he took on too many patients.

It’s not uncommon on P.E.I. to see dedicated country doctors leave behind staggering patient lists of 5,000 or more. They were obviously prepared to work long hours. A younger generation tries to juggle the needs of patients with his or her family life and personal interests. There must be a balance that satisfies patients, and provides an acceptable quality of life for the doctor.

Dr. Giordani said he was shocked at the behaviour of some patients, from shouting, curses, threats and demands. A radical solution was soon posted in his office. It was likely not the best option and really doesn’t solve the problems for patients, himself and Health P.E.I. The provincial body tried to persuade the doctor out of his plan because patients cut from the Crapaud practice will become a problem for Health P.E.I.

Dr. Giordani’s solution was to reduce his list by randomly removing 250-500 individuals from his 2,000 patients’ list. This method was selected to avoid legal action based on discrimination. Using a lottery to reduce his patients will still leave bad behaviour patients in his care and other, innocent victims will be without a family physician.

The new reality is that 2,000 patients are too many for a regular practice, and most new doctors want that number reduced to 1,200 to 1,500. It means that Health P.E.I. will need to find more doctors - where two will be needed to replace a retiring doctor.

It’s time for all sides to cool down in the South Shore community, step back and work out a solution. Health P.E.I. has offered to provide help to ease the workload on Dr. Giordani. Patients, facing dire options, should be more respectful and understanding. Dr. Giordani might reconsider his decision and allow more time for things to work out.

It's time for a second opinion by all sides.

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