i believe that Doctors are paid depending on how many patients are in their practice - it is not per individual, more a sliding scale. They also get extra incentives for things like the level of patients who have smear tests or vaccinations for children. They also get money for the services they offer within their practice and if they do their own out of hours service. So I think that if you dont go, they are getting paid for you anyway. If you don't have a good rapport with your Doctor, you can move to another any time by going to a new doctor and requesting to be added to their list. If they accept you, they will request your file from your old doctor - it is quite simple really. You need yo bear in mind that if your new doctor does not cover your area, they will not supply you with home visits etc (but then what doctor does nowadays!)