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10. Dr. Jones’ large multi-specialty clinic provides a year-end bonus if his percentage of external specialist referrals is below the clinic average.
#Response DateComment
1.Wed, 3/14/07 12:23 AMNo COI if the same service is available within the practice and quality metrics are equivalent or better.
2.Wed, 3/14/07 1:58 AMIt depends if the specialists in the group are of high quality and can provide the necessary care required.
3.Wed, 3/14/07 3:22 AMThis is more an issue of professional ethics than a COI per se
4.Wed, 3/14/07 4:56 PMIf good specialists are available withing the practice/
5.Wed, 3/14/07 10:04 PMdoes this compromise patient care?
6.Wed, 3/14/07 10:10 PMIf there are appropriate in-house referral options and if out-of-house referrals are screened by a panel of peers for appropriateness, then he could be "docked" for excess referrals out without having patient care compromised.
7.Thu, 3/15/07 1:04 AMNot sure this is a COI. Seems more like just poor medical practice.
8.Sat, 3/17/07 1:33 PMThis is difficult. Is patient care hampered by this policy of limiting referrals? Individual provider practice styles will greatly influence this policy as well.
9.Mon, 3/19/07 12:13 AM If the quality of care provided by Dr Jones is excellent there is no conflict
10.Mon, 3/19/07 4:17 PMDepends on the quality of care maintained and whether services of similar standards are secured for patients.
11.Mon, 3/19/07 5:30 PMDr. Jones is caught between the lure of $ and the duty to refer when appropriate.
12.Mon, 3/19/07 9:11 PMdepends on size of bonus in relation to overall income
13.Mon, 3/26/07 3:14 PMcould be a COI, but if the practice had procedures in place to review providers for care quality, the likelihood would be reduced
14.Mon, 4/23/07 3:41 PMIt would be OK if Dr. Jones always refers to the best/most qualified specialist, no matter if internal or external
15.Tue, 4/24/07 1:37 PMIf there is a quality review to be sure that referrals are made when appropriate it may not be a COI. HMO's use this technique to change Dr. behaviors.
16.Thu, 4/26/07 9:19 PMwould need to be based upon quality measures not just volumes
17.Tue, 5/8/07 3:29 PM...
18.Wed, 5/9/07 1:02 PMIf Dr. Jones believes the specialists in his clinic are of equal or better quality than outside specialists, then no conflict exists.