-----BEGIN PGP SIGNED MESSAGE-----
Hash: SHA1
You are not obliged to do any referral. It is a clinical decision.
I probably tend to be though a fair bit looser with my referral criteria
in case of private referrals - it is after all not NHS money spend, but
BUPA or patient's own, i.e. none of my business, not in my contract and
totally beyond my role as NHS gate keeper. If BUPA whishes me to act as
guardian of their money/referrals I am quite happy to enter negotiations.
As a bottom line in NHS referrals I would ask myself: can I deal with
this successfully here?
And in private referrals : Does this need a doctor, any doctor? If yes
and the patient wants a referral, then this means they do not trust me
and my knowledge enough to sort it - so best to move them on. It will
keep everybody happy.
My personal line is drawn when referral requests are simply stupid - to
some named "expert" of non-disease somewhere far else or to
chiropractors, homeopathists, voodoo healers etc. Go, if you like, but
do not expect me to endorse it.
With the original example - physio referral in minor injury - I would
think the same applies as I said above. If you think the ankle needs
anything beyond rest and elevation - i.e. any kind of exercises and the
patient wants a referral, then I presume your advise is not deemed good
enough - pass them on.
But you are not obliged nor is your referral strictly necessary. Private
medicine means after all just that. They can go to the physio and pay
themselves. Just BUPA will not shell out, and that is none of your or
mine business.
And fees - it is unethical to charge for private referrals, it is
illegal to dicuss the level of one's fees and it s none of the BMA's
business to set or advise on private fees.
Peter
North Mike (F81717) Maylandsea Medical Cent CM3 6AH wrote:
> Many years ago, patients used to bring in forms for us to sign, for which we
> charged. I've not seen one of these for years. I heard at the time that they
> were getting the consultant to sign them instead, which seemed to make a
> mockery of any sort of gatekeeping role.
>
>
>
> It seems very odd that BUPA etc don't ask us to confirm in some way that we
> think it appropriate that they should shell out for the referral. It would
> seem very much in their interest to do so.
>
>
>
> Is there any BMA guidance on charging for referring, 'validating' or
> 'screening' in these situations?
>
>
>
> Mike
>
>
>
> -----Original Message-----
> From: Paul Miller [mailto:[log in to unmask]]
> Sent: 28 November 2007 19:35
> To: [log in to unmask]
> Subject: Re: Do I have to refer privately?
>
>
>
> Mike
>
> How much are BUPA paying you to do their screening for them? Can I get
> some?
>
>
>
>
> On 28/11/2007, Paul Bromley < [log in to unmask] <mailto:[log in to unmask]>
>> wrote:
>
> I think you are probably both correct. However, faced with this
> situation I would opt for the easy life. I personally think that BUPA
> encourages this by telling the patients to get the form signed.
> Increasingly these days with NHS patients if they are demanding
> referral I refer - however I do state in the referral that the patinet
> is demanding referral. Perhaps not in this case, but there is a no-win
> situation if the patient subsequently had pathology and did not refer.
> I am NOT a high referrer.
>
> Paul Bromley
>
> On 28/11/2007, Geoff Schrecker < [log in to unmask]
> <mailto:[log in to unmask]> > wrote:
>> I think you are a trained clinician, and if you don't think he will
>> benefit from physio, but say yes so that he can claim from BUPA you
>> are colluding in fraud. You have done right.
>>
>> Cheers Geoff
>>
>> On Nov 28, 2007 5:41 PM, North Mike (F81717) Maylandsea Medical Cent
>> CM3 6AH < <mailto:[log in to unmask]>
> [log in to unmask]> wrote:
>>>
>>>
>>> Just had a patient slam out because I have said that I do not think his
>>> ankle requires physio. (Turned it over yesterday, minimal bruising and
>>> swelling, walking normally, needing no analgesia). He insists that as he
>>> belongs to a scheme that he is entitled to use it on each and every
> occasion
>>> that he wishes (several previous referrals). I feel I have a duty to
> refer
>>> only if I think it appropriate, not on demand, and that is why BUPA have
>>> told him to ask me for a referral. I have said that I am happy to
> discuss it
>>> with BUPA if they care to phone me. He is quite sure that if he asked
> the
>>> physio if it needed physio he would say yes. I agree that he would!, and
>>> BUPA know that, and that's why they ask him to see me first rather than
>>> self-refer.
>>>
>>> What do you think?
>>>
>>> Mike
>>
>>
>> --
>> Please avoid sending me Word or PowerPoint attachments unless by prior
>> arrangement.
>> See http://www.gnu.org/philosophy/no-word-attachments.html
> <http://www.gnu.org/philosophy/no-word-attachments.html>
>
>
> --
> Best Wishes
>
> Paul Bromley
>
> www.informatiks.com <http://www.informatiks.com>
> Custom EMIS LV Software.
> vuE | GPLabels | GPDocs | eGFRChecker
>
>
>
>
-----BEGIN PGP SIGNATURE-----
Version: GnuPG v1.4.6 (GNU/Linux)
Comment: Using GnuPG with Mozilla - http://enigmail.mozdev.org
iD8DBQFHTn6iGZ/1MokWdcsRAtKgAKDKn/IG23xNa2gn83NV4/O6Bliv3gCeIUoU
lxjp3XWzmdxGbfu4za0Dhik=
=AZ5o
-----END PGP SIGNATURE-----
**********************************************************************
This message may contain confidential and privileged information.
If you are not the intended recipient please accept our apologies.
Please do not disclose, copy or distribute information in this e-mail
or take any action in reliance on its contents: to do so is strictly
prohibited and may be unlawful. Please inform us that this message has
gone astray before deleting it. Thank you for your co-operation.
NHSmail is used daily by over 100,000 staff in the NHS. Over a million
messages are sent every day by the system. To find out why more and
more NHS personnel are switching to this NHS Connecting for Health
system please visit www.connectingforhealth.nhs.uk/nhsmail
**********************************************************************
|
