Should doctors be paid for performance?

[mommax3]

Right. But the fact is, insurance companies are the payors, not hospitals. Not all physicians, a good number, are not employed by hospitals at all.

This. DH has not been affected too much by this *yet*, but he is not hospital employed, and insurance companies are the devil.

[GrayMatterWife]

If physicians are paid based on their performance, then they should be permitted to (1) screen their patients based on their overall health and their previous compliance with medical directions and (2) drop patients who are being noncompliant.

Result? People with obesity-induced diabetes would not get any primary care. Neither would smokers, Or people who have unprotected sex. Or intravenous drug users. Or non-compliant mental health patients.

But the perfect among us would have AWESOMELY SHORT waiting room times!

We also should pay priests based on their performance. The fewer confessions they have to hear, the better. Screen potential parishioners for their state of grace.

[Flynn]

Right. But the fact is, insurance companies are the payors, not hospitals. Not all physicians, a good number, are not employed by hospitals at all.

I don't disagree with this but -- right or wrong -- I think procedure based docs who aren't employed are becoming a smaller and smaller number. Long term I think they will all become employed (years and possibly a generation from now) if things stay as they are now. Non employed procedure based docs are an endangered species. It's not looking good for them to survive.

[v-girl]

Please tell me this would not apply to genetics/metabolics. And for pediatrics, compliance depends mostly on the parents of the patient, not the actual patient.

[HouseofWool]

V- it will be all patients. And yes, we have issues with non-compliant parents of our peds patients.

[v-girl]

I guess they would grade on whether treatment is effective? Because his patients aren't cured.

[PrincessFiona]

One thing being graded right now, Veronica, is patient satisfaction. How listened to did the patient feel? How happy were they with the visit.

I think physicians do police their own. Here, we have a neurosurgeon who lost all hospital privileges and another surgeon whose contract was not renewed. Multiple docs have not made partner. Beyond that, doctors are selective about who they refer to. There is policing from within happening.

The problem with how performance is now being evaluated is that it's based on how happy the pt is and not necessarily on good medicine. It also refers to health markers that are outside of a physicians control ... like their compliance to their own diet. This is ridiculous. Doctors will start cherry picking patients who meet insurance standard ideals.

[peggyfromwastate]

Should doctors be paid for performance?

Also the surveys--- Dissatisfied patients are more likely to fill them out. I for one am sick to death of surveys. On line health portals are stupid bc they don't allow me to track most of my kids (here above 12 the parents are denied access). My dh spent about 2 hours last night responding to patient questions sent to him through the online system. Enough already!!!! Make an appointment and come in--- don't harass your doctor online and expect free medical advice. (One patient emailed him 5 times in one night!!!! Really???)