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Re: Medicaid and InsuranceFrom: ainsron (ainsron@sbcglobal.net)Mon Jul 19 09:47:22 2004
Over the years, I've discharged very few patients from my practice. Even though I understand the importance at times from a medical-legal standpoint, I have a problem with the concept of referring these patients to another physician. I live in a small medical community, all three of the obs in town share a weekend call schedule and there is a 1:3 probability that an ob patient I discharge from my practice would still be seen in labor and delivered by me. These other physicians are also my friends. How in good faith can I refer a problem patient that I no longer want to see to someone whom I must work with closely? The thought of referring these patients to other physicians in the two surrounding communities that do obstetrics is also bothersome to me. What I have done is simply give them a list of other physicians to contact. If that is considered a referral, fine. On the other hand, neither I or my staff are going to make the calls for them, as we would in referring a patient to a general surgeon or urologist. In a larger medical community you can easily refer a problem patient to the university clinic, to the new guy in town or to a colleague you dislike; however, for many of us, those options simply do not exist. Ronald E. Ainsworth Geff- The key to releasing patients from your practice is to do it "without cause." Although it's uncommon for us to fire a patient, when we do they receive a certified letter stating that we are unable to care for them, and that they have 30 days to receive emergency care from us. After that they need to be under the care of a new physician (or midwife). Of course, we are happy to provide a referral, and once a release is signed, send records. We enclose a release form for the patient to fax back to the office. Best wishes, Ashley
-- D. Ashley Hill, MD Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, Florida
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