In-Reply-To: <[log in to unmask]>
In Reply to
> "Patient Allocation":
> >-----------------------------
> Soon after first coming into a large group practice in about 1984 I was
> allocated a patient outside our practice area. The patient didn't want
> to
> be registered with a yellow or black doctor because she claimed that
> she had
> once been raped by a coloured man. Our practice was bursting at the
> seams,
> and we were all anxious at the possibility that boundaries that had been
> strictly enforced would suddenly be "rent asunder". I couldn't find
> anything in our terms of service or indeed the Red book at that time
> that
> said the patient couldn't be allocated, but ToS seemed clear that I
> wouldn't
> be obliged to visit.
>
> My recollection is that after various discussions it seemed I had three
> options:-
>
> Accept the allocation
> Appeal to the FHSA formally (a procedure existed in those days - I have
> no
> idea now)
> Remove the patient from my list after an interval (3 months if I felt
> charitable, 1 day given the extenuating circumstances if I did not feel
> charitable).
>
> I opted for the second, and presented by case to the full FHSA. ( I
> hear
> some of you saying fools rush in where ...)
>
> I received a largely very polite hearing, probably partly because it
> was so
> obvious that they could have made mincemeat of this new principal rather
> easily. The only hostility was from one of the medical members, who
> after
> discussions with LMC colleagues I had very much expected to be on-side.
>
> Needless to say the verdict went against me, and the patient was indeed
> allocated to my list. She remained there quite happily for a number of
> years before moving on. Our practice boundary was not invalidated, but
> I
> have never forgotten the lesson that HA's have the power to nobble GP's
> and
> find loopholes that allow them to do the unexpected. (Not that we are
> powerless ourselves)
>
> If the patient is significantly outside your area, a word with the LMC
> would
> appear well worthwhile. Pragmatically the best solution if you have LMC
> support will probably be not to challenge the allocation but to remove
> the
> patient yourself ASAP. All that said someone has to look after
> difficult
> patients under the present system. Perhaps the real issue is that some
> (very few) patients are so dangerous or disruptive that they should
> have all
> their care through some other service.
>
> Whatever the outcome - you're not alone.
>
Thanks Julian
I have removed the patient stat. I agree that someone must care for him
but I felt threatened by the high-handed nature of the allocation:"I
haven't phoned to discuss this, I've phoned to tell you and you have no
choice" is almost a verbatim quote from the HA manager concerned.
I have taken a rare stand here. The real shame is that the manager
concerned is kind and efficient as a rule so what has happened to her to
make her think that this is the way to treat her local GPs?
Thank you all for your helpful comments. I found the response heartening.
Leonard
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