Dear 'londonphysio',

Your first paragrah disappointments me greatly, particularly as you feel that your competitors would 'ditch' you in such a way. If that is true, you have my sympathy. I am pleased to say that, outside of London (as I am), that appears, so far, not to be the case. Time will tell!

I don't agree that a successful business model is to get what you can out of each and every patient that attends. Each should receive what their condition demands - no less and no more.

Your clinical autonomy is always at risk when you have to justify, to a third party, your actions, based on your professional opinion. The contract for provision of service is between you and the patient, not involving any third parties. How that patient funds their treatment is their affair and should not be yours.

I applaud the fact that you did not drop your fees. From the sound of it, you provide a valuable service which should receive a market based remuneration, and not one that is 'capped' by a third party.

If you could adjust your targetted market to achieve (much) less than a 50% dependance on one diminishing PMI, maybe your cost/benefit analysis could work more in your favour than in theirs.

Whatever, I wish you the very best with your tender, although I am unable to support the action, for reasons well described on this blog.

Best wishes,

Mr Manipulator