Bob Moylan wrote in a message to Kalera Ashley:
 BM> Kalera Ashley (On 03 Mar 98) said this..? to Mark Probert
MP> KA>What disturbs me most is how many GPs are willing to prescribe these
MP> KA>medications with little or no background in diagnosis and treatment
MP> KA>of the  conditions for which they are appropriate.
 KA> MP>
MP> How do you know that there are so **many** GPs who do this?
 KA> Insurance company policy.
 BM>  You have evidence that this is 'insurance company' policy?
 KA> After observing it a couple of times, I asked my doctor. Aetna, among
 KA> other insurance carriers, discourages GPs from doing referrals and
 KA> actually offers kickbacks for NOT doing referrals,
 BM>  Aetna offers kickbacks?  Sounds illegal to me. It also
 BM> sounds like a  fairy tale.  I rather doubt that your doctor
 BM> told you that "Aetna,  among other insurance carriers"
 BM> offers kickbacks.  Any MD caught  taking a kickback for not
 BM> making referrals if/when indicated would  more than likely
 BM> lose his/her license and his/her malpractice  insurance
 BM> company would have to defend a suit.
 KA> so many doctors are
 KA> in the uncomfortable position of being unofficially pressured to
 KA> prescribe medications they aren't really qualified to prescribe.
 BM>  Evidence....
There have been law suits about non-referrals and legislation to stop that 
practice in my area.
Basically, the referral money si set up like this:
The doctor is paid X dollars for each patient that he cares for under the 
plan.
This is his "salary".
Like any good corporation, these companies give year end bonuses.
The doctor is told at the beginning of the year how much that bonus will be.
However, the doctor is told that the bonus figure given will be reduced if 
the number of referals exceeds a certain amount.
The higher the number, the lower the year end bonus.
This gives the doctor a financial incentive to not refer.
Alan
Team OS/2,
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internet: alanrackmill@mindspring.com
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