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