When Communication Breaks Down: Why We Parted Ways with a Patient

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At Seeds of Health, we believe Direct Primary Care is built on relationships, mutual respect, open dialogue, and shared responsibility. It’s a partnership, not a one-way transaction.

Recently, I had to decide to dismiss a patient who demanded a free month of care after feeling his non-urgent email wasn’t answered quickly enough – okay, it wasn’t difficult this time.   This patient had reached out by one communication method, and when he didn’t get a response in the expected time frame, he sent another message via the same avenue.  To be fair to this patient, he should have received a response to the first reply in a “timely” fashion.  Timely communication has been our focus area of improvement this year.  To engage patients in the process, we have encouraged them to escalate their communication to a phone call if needed.  Unfortunately, he didn’t call us.   

I hold space for honest feedback, but that wasn’t the real issue here.  My spidey senses told me he wouldn’t be a good fit at our meet and greet several months before.  I didn’t listen to my gut, of course. I gave the patient the benefit of my doubt, and we proceeded.  This incident was one of multiple microaggressions that sealed his fate with our practice. He just wasn’t a good fit for our practice, and continuing the relationship would only lead to resentment and further deterioration in our relationship.  

So, we owned the communication breakdown with the patient and told him we didn’t feel our practice would be a good fit for his ongoing care.  We recommended that we sever ties and offered him one remaining month at no charge until he could find a new primary care provider.  

I’ve learned in this work that care thrives on a solid doctor-patient relationship. I deeply value patients who come to the table willing to talk things through—not just when things are going well, but also when there’s a hiccup. That’s how trust is built. I have also learned to stop dismissing my gut because it’s usually right. 

I’m committed to serving patients who value relationships and clear, kind, two-way communication. That’s the heart of this model, and it’s what makes this work so meaningful.

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About Angela Andrews, MD

Dr. Angela Andrews is a board-certified Internal Medicine and Pediatrics physician, health coach, wife, mom, and lifelong athlete. When not spending time with her family or caring for her patients, she is training for her next competition. Dr. Andrews graduated from the University of Michigan with a Bachelor of Science in Engineering in Biomedical Engineering and worked at General Electric Healthcare Wisconsin for nearly five years before returning to her dream of becoming a doctor. She received her medical degree from Michigan State University College of Human Medicine. She completed her Med-Peds residency at the Detroit Medical Center & Children's Hospital of Michigan in Detroit, MI. After 8 years in the system, Dr. Andrews opened Seeds of Health Direct Primary Care in Grand Rapids, MI in February 2014. Her personal journey with fitness, nutrition, and lifestyle medicine training was a key factor in her decision. She spent years trying to figure out how to incorporate this experience into a “standard” clinical practice, before finding a natural fit within Direct Primary Care. Dr. Andrews is passionate about helping patients address the root cause of their mental and physical conditions and guiding them to cultivate healthy habits around exercise, good nutrition, and mental well-being. Dr. Andrews lives in Byron Center, Michigan, with her husband and exercise companion, Joseph VanEss, their son, Myles, and her two bonus children, Griffen and Quinne. She engages in various fitness activities (CrossFit, running, swimming, yoga, and bodybuilding) and enjoys gardening, tackling projects around the house, and building things out of wood.