Wendell,
I think it has to be that simple. I don't have any ill will if someone chooses to go elsewhere. My ego may be bruised, but it is best to let them go their own way.
However, I am not going to kick out any of my existing patients, and replace them with higher reimbursing patients. As I try to stay in business with the mounting difficulties being posed each and everyday, I think of my bruised ego, and get over it rather quickly if I can put in a higher reimbursing patient that may meld with me better over time anyway. This patient (that chose to leave for economic reasons) just gave me more of an opportunity to stay in business a day longer. No hard feelings, just simple math, and a hope that the new replacement will be better for me and my practice in the long run, both on a personal and financial front.
However, if I had to choose between a good paying pain in the *$$ patient versus a self pay nice respectful patient---it would be the latter everytime.
