He [Rivo] said one doctor might get 41 percent of patients needing mammograms to have them done while another doctor gets 90 percent compliance. Under the concept of pay-for-performance, perhaps one doctors should be rewarded more than another.

One student immediately objected: ”It’s not your fault,” he said, defending the doctors. Patients should be held responsible for doing what’s right, not doctors.

”So you should drop bad patients?” Rivo asked. The student didn’t answer.

I suppose the students are “idealistic lambs”. In fairness, though, they are not law students. Debate may not have been their strong point in college.

Personally, my answer would have been “yes”. Under P-4-P, the doctors should drop “bad patients” who will not quit unhealthful habits. The doctor didn’t create the incentive, the insurance company did. The doctor’s ethical choice would be to not sign in the first place I suppose. I’d have brought that up as well.

Also in fairness to the medical students, they are in a position where faculty can throw them out on a whim. The school sent them to the insurance company, with implied endorsement. If I were a medical student in that position, I’d be hard pressed to argue with an insurance company executive who questioned my ethics.

Of course, now that I’m out of that position, if an insurance executive questioned my ethics, I’d suggest in that public forum, that the insurance executive wouldn’t know what ethics was if it bit him in the ass.

I know, I know. Because doctors couldn’t control themselves in the 70′s and 80′s. Great, so now we have a whole new subset of greedy b*&%$#@, and they arent even seeing patients.

Makes me so ANGRY!