But, your situation is completely different. A good portion of your patients leave because they get better. If they can't afford speciality care, then the specialist across the street likely isn't much better.
I think you hit on the head, actually, when you stated it violated a trust. The difference between a plumber and a doctor is that the plumber does a job for you, and you may not call him or her again for months. The plumber doesn't receive a release form asking him to send all of the information on your pipes to the next plumber.
Doctors are different (in my perspective). We are the patient's doctor every day whether they come in or not. I, hopefully, give the best I can to the patient. Which, I happen to think is the best around. If they are not happy or don't perceive that I am giving good care, then they should leave. And, it is unlikely they will ever return. But, when a patient basically says to me, "I like you as a doctor, in fact I find you to be outstanding and if I didn't have a better deal somewhere else, I would stay except I have a better deal somewhere else. I just think we provide the level of care that may cost more. We can't compete with the FQHCs and the hospital practices. So, for the most part, if they leave for a better deal, and then don't like it, there is that other practice in town.
