We've had a higher attrition in two years. Over 700 seen for just under 500 current patients.
We have a severe PCP shortage here for years so we've had a number see me for various problems that they can't get addressed elsewhere and then stop paying or move on a few months or a year later. We've been quicker to discharge them when they stop paying this year.
We've lost some who decided they didn't see me enough to warrant paying $40/month and more who picked up HMO insurance when their or their spouses employer changed plans.
We've had a lot more deaths than I would've expected for such a small panel (very sick patients) but not even close to 60% of discharges.