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<blockquote data-quote="Marguerite" data-source="post: 65374" data-attributes="member: 1991"><p>Heather, you said, "also cannot imagine that she's dropping because of fibro. The letter was dated the day before the lab work came back."</p><p></p><p>Sometimes lab results are phoned through a day or so earlier than the printouts come in. Also, if someone senior in the practice was checking out possibly long-term liabilities to the practice, they may have noticed the likelihood of a prospective FM label heading your way - ANY patient who has a history of six months or more unspecified malaise, muscle aches, fatigue; coupled with all blood work coming back negative - from a medical practice point of view, patients like this take up far too much valuable time. A lot of resources and doctor time go into seeing and eventually (maybe) diagnosing that one patient. If, instead, they can use that doctor time to see 10 patients, their stats look much better. is it possible that they're trying to sell the practice? Or maybe working towards selling the practice? It is something to consider - an incoming doctor will pay more for a practice with a higher number of patients. If they are systematically eliminating the patients who have taken up more than average doctor time in the last six months then patients needing more long-term care, or who have had a more difficult year than usual, would find themselves eliminated. It's part of making the financial side of the practice look good - it's easier to sell a practice when the books are in good shape. This isn't just patients statistics (numbers, overall costs, etc) but also the spectrum of diagnoses. A sports medicine practice, for example, will attract a certain kind of doctor which will attract a certain range of patients, so the change perpetuates. </p><p></p><p>A practice that comprises mostly senior citizens needing chronic care is going to not attract someone interested in treating workers with colds & flu, or bandaging sprains. </p><p></p><p>I do wonder if, also on their 'hit list' are drug addicts trying to reform, any patients with chronic conditions and 'needy' patients who would see the doctor about twice as much as average.</p><p></p><p>In Australia decisions like this would be made by the practice manager, who is not necessarily medically trained. They are accountants and managers, not doctors as a rule. Any actual attempt to formally 'move patients on' without an acceptable reason would be actionable. But it probably does happen, informally. There are laws, and there are ethics. They're not always the same thing. But discrimination is generally actionable, in this day and age.</p><p></p><p>I would be quietly sniffing around, maybe find a cooperative doctor friend to find out of this practice is about to come on the market. Don't ask anyone associated with the same practice; ask someone totally away from the area. And, of course, meanwhile get your information in writing and make notes of what you are told. If making a fuss in the waiting room gets any other patients talking to you about also being excluded, see if you can find a link between you, that could explain the reasons. </p><p>Another sneaky trick to try - get someone you know but who is unknown to the practice, to telephone and try to get an appointment. Invent a couple of different conditions - 1) he/she (there's a start) has been feeling feverish and with coughing and sneezing for a few days, need a medical certificate for work. 2) - feeling run-down for several weeks, thought it was flu but the fatigue hasn't gone, feeling depressed, having trouble sleeping, maybe need a check-up to make sure it's nothing serious.</p><p>I'm betting that if they take 1) but not 2), my theory is right - they're excluding the "time wasters". Utterly reprehensible, except to accountants.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 65374, member: 1991"] Heather, you said, "also cannot imagine that she's dropping because of fibro. The letter was dated the day before the lab work came back." Sometimes lab results are phoned through a day or so earlier than the printouts come in. Also, if someone senior in the practice was checking out possibly long-term liabilities to the practice, they may have noticed the likelihood of a prospective FM label heading your way - ANY patient who has a history of six months or more unspecified malaise, muscle aches, fatigue; coupled with all blood work coming back negative - from a medical practice point of view, patients like this take up far too much valuable time. A lot of resources and doctor time go into seeing and eventually (maybe) diagnosing that one patient. If, instead, they can use that doctor time to see 10 patients, their stats look much better. is it possible that they're trying to sell the practice? Or maybe working towards selling the practice? It is something to consider - an incoming doctor will pay more for a practice with a higher number of patients. If they are systematically eliminating the patients who have taken up more than average doctor time in the last six months then patients needing more long-term care, or who have had a more difficult year than usual, would find themselves eliminated. It's part of making the financial side of the practice look good - it's easier to sell a practice when the books are in good shape. This isn't just patients statistics (numbers, overall costs, etc) but also the spectrum of diagnoses. A sports medicine practice, for example, will attract a certain kind of doctor which will attract a certain range of patients, so the change perpetuates. A practice that comprises mostly senior citizens needing chronic care is going to not attract someone interested in treating workers with colds & flu, or bandaging sprains. I do wonder if, also on their 'hit list' are drug addicts trying to reform, any patients with chronic conditions and 'needy' patients who would see the doctor about twice as much as average. In Australia decisions like this would be made by the practice manager, who is not necessarily medically trained. They are accountants and managers, not doctors as a rule. Any actual attempt to formally 'move patients on' without an acceptable reason would be actionable. But it probably does happen, informally. There are laws, and there are ethics. They're not always the same thing. But discrimination is generally actionable, in this day and age. I would be quietly sniffing around, maybe find a cooperative doctor friend to find out of this practice is about to come on the market. Don't ask anyone associated with the same practice; ask someone totally away from the area. And, of course, meanwhile get your information in writing and make notes of what you are told. If making a fuss in the waiting room gets any other patients talking to you about also being excluded, see if you can find a link between you, that could explain the reasons. Another sneaky trick to try - get someone you know but who is unknown to the practice, to telephone and try to get an appointment. Invent a couple of different conditions - 1) he/she (there's a start) has been feeling feverish and with coughing and sneezing for a few days, need a medical certificate for work. 2) - feeling run-down for several weeks, thought it was flu but the fatigue hasn't gone, feeling depressed, having trouble sleeping, maybe need a check-up to make sure it's nothing serious. I'm betting that if they take 1) but not 2), my theory is right - they're excluding the "time wasters". Utterly reprehensible, except to accountants. Marg [/QUOTE]
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