Doctors are failing to provide Americans with the best care due to a revolving-door system of medicine in which doctors are rewarded for sacrificing quality to see patients as fast as they can
Bingo. We have an increasingly fee-for-service based reimbursement system. That means that physicians are paid for every service they do: i.e. more patients/procedures/tests = more revenue.
This differs from the capitation model, where physicians are paid more to do less. However, with all the negative press that HMOs receive, this model is slowly fading away.
Pay-for-performance is one way to reverse this trend, but such programs are not yet financially viable, or are too expensive to implement.
Fee-for-service rewards quantity over quality and procedures over cognition. Each physician practice is now a small business. Like any business, if you don’t make enough revenue, you go bankrupt. The only ways to increase revenue is to i) do more procedures, or ii) see more patients. Thus, to stay in business, physicians have no choice but to see more patients. The alternative is to be out of a job.
Until this changes, expect the conveyor-belt to continue running. (via symtym)
Related posts:
- Can doctors resist the temptation of money?
- Patients do not want their doctors paid on salary
- Volume is key
- Electronic records and economic sense
- Consumerism and health quality
- Doctor salaries: The free-market experiment
- Blue Cross targeted its "rat out" letters to capitated doctors
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In a related note:
http://www.nationalreview.com/derbyshire/derbyshire200505100802.asp
Money quote:
“** In the matter of healthcare funding, for example, the public-private mix is about 77-23 in Britain (£54bn out of £70bn for 2003). The latest figure I can find for the USA is 43-57 for 2001. The ratios are on a path of rapid convergence. When, later this year, the money for George W. Bush’s colossal expansion of Medicare begins to flow, the public-private mix in the USA will tip to majority public funding, just like Britain’s.”
Another option is to drop out of the insurance plans completely, lower your overhead, and be able to spend the time again.
http://www.simplecare.com/
http://www.emergiclinic.com/
The doctor that runs the PATMOS emergiclinic, his regular office fee is about the same as the COPAY being contemplated under TennCare.
We had a superb clinic near us (till it burned down) that took no insurance, did employment-related drug tests as bread and butter income, took no appointments, and charged a flat $35 to see the dr. He was great, always ready to say when it was beyond what he could do and you needed a specialist. Best medical relationship I ever had. Why don’t more drs do that?
To the Anonymous in the thread below, unfortunately something about the site prohibits me from reading comments past halfway through your last one. I apologize for not responding. I’m sure it was rife with good information.
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