~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Hi Kevin, A very difficult situation. Although not clinical in nature, I was involved with a situation where the attributes were very similar. The data had a pretty damning look to it. The manager in question wanted to take decisive action in the same manner that you did. I refused to allow the manager to proceed, arguing that while the data seemed pretty accurate, the manager could not cleanly demonstrate that the effect (as represented by the data) was the result of one and only one cause. There could have been several explanations that could give rise to the exact same data. I asked the manager to consider the difference between what we know and what we think we know, suggesting the first can be used for decisions and the latter is best used for selecting the next set of questions. Best regards, Bill At 11:54 AM 10/21/97 -0500, you wrote: >~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >This message is from PedTalk! To reply to the group, use "" >~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >I would be interested in others opinions of this. Yesterday, I got a >call from the gmom of a patient who seems reliable and she reported to >me that the uncle of one of the patients I have on Ritalin for ADHD is >selling his Ritalin and mixing it with crystal. She called to warn me >because the mom was coming in later that day. Well, sure enough she >tried to convince me that his dose wasn't enough, even though he is >doing ok in Head Start, and she came in with her neighbor who brought >her daughter in for, you guessed it an ADHD eval. Her other daughter is >also on Ritalin. Now, I have seen these kids and believe their symptoms >are legitimate, but I have opted to separate them all from the >practice. I also notified the local police dept. I would be interested >in others' opinions. I also notified the other physicians in our group >about this. Obviously, I have no proof, but didn't feel the risk >justified any further relationship with them. I also have separated the >child's cousins as they also have one child with ADHD. Kevin Kramer, >MD,FAAP > > > --------------------------- Medical Practice Systems Inc. (216) 382-7111 (Voice) and The Health Systems Group http://www.hlthsys.com Mergers - Planning - Management Services Marketing - Managed Care - Education & Training