not if you refuse to drop your prices. I think, for central London, having 40% self paying patients is pretty high. The only reason my BUPA % is high is because of a corporate contract. I have tried to diversify the way my patients are funded and not 'put my eggs in one basket', but in central london the fact is that the majority of patients will be claiming on their work policy. I have takent he view that it is best to fight this from within. I agree that the tender as stands may be the thin end of the wedge, but I can 'out statistic' pretty much anyone. I audit 100% of patient notes for example.
I think other peoples practices are relevant in this discussion. I think they have brought this on us. I am not surprised that BUPA says that 80% of the physio bill goes to 10% of practices. With a variation of £20+ between the cheapest and the most expensive physio 30 min sessions in central London, it is quite feasible that the cost could easy be quadruple when comparing one practice to another, in the same area, if you take sessional averages into account.
Until we can evaluate outcomes reliably, this cannot be justified. this is why i take outcome measures for all patients, even if they are not deemed reliable at present. It is my 'insurance policy' against further, more sinister actions by the PMIs.