Difficult patient. Believe me they do it... When I worked in eye care I remember asking what the certain flags were on some charts. They said were because the patient was not really a patient but an "im-patient". (Attitude issues, always debating a bill, etc.) When you "fire" a doc i am guessing you should have documentation of neglect or miscommunication, etc. Because with being locked into HMO's we are just sent to ANOTHER doc which is of course an ASSOCIATE of your old doc. And I assume many of them are friends as well as colleagues. Are we really going to get any farther with a doc in the same "practice"? What is your advice? I just asked for a change of doc for Rhuematology as in 8 years have had no good advice or any empathy, hope, or even just common decency from my doc (and he is listed as one of those "specializing" in CFS in Madison WI). He told me to buy a book and get my primary care doc to do as much as she would as far as tx. (From the Fatigued to Fantastic book). I didnt' get a single bit of help except for when I pushed for IV therapy when I was proven to be suseptible to dehydration and doc said for some reason CFS patients don't absorb fluids into cells like other ""normal"" people. That turned out to be a fiasco because they passed it off to a nurse that didn't know what she was doing and the whole thing put the clinic's schedule out of whack because it took hours to finish. And they were mad at me. Anyway, How do you gracefully and yet assertively fire a doc and then explain to a new doc what your expectaions and needs are and actually get some help or ACTION!!!