If there’s no incentive for productivity, many physicians will go to banker’s hours to the detriment of patients:
The problem with a flat salary is that there’s no incentive to maximize work. Show me a salaried doctor (without a productivity bonus) and I’ll show you one who believes strongly in his right to get home by 5PM, regardless of medical problems coming through the door, or over the phones, that day. This translates into doctors who send acute problems that could be handled in the office to the emergency room to avoid hampering their own schedules, doctors who schedule longer appointments, or block off time to allow extra time for paperwork during the day.
Related posts:
- Pharmacists and physicians
- Should doctors be on a salary?
- Paying doctors by the hour
- Interruptions when doctors see patients and how that affects care
- Ordering tests for other doctors
- Unable to provide proper patient care, emergency doctors are suing the state of California
- Medicare’s dismal pay for performance
KevinMD.com on Facebook
{ 4 comments }
I don’t understand what is wrong with doctors’ wanting to go home at 5:00 or to have extra time during the day for paperwork.
It’s true that being salaried provides less of an incentive to maximize the amount of work done, but plenty of other professions seem to get along just fine with salaried workers. I don’t think I’ve read any articles complaining that salaried pharmacists are leaving prescriptions to be filled the next day, or that salaried computer programmers are taking time to fill out paperwork instead of pounding out as much code as they possibly can. Some of my college professors used to take a really long time to grade exams – maybe they should be paid based on the number of papers they grade each day, or the number of pages of lecture notes they manage to deliver.
I think there’s 2 different possible assumptions that this article is based on: one is that doctors are lazy bastards who will avoid doing their work, to the detriment of their patients; the other is that unlike other professionals, doctors don’t deserve to be able to go home at 5:00 to see their families, or to take a decent lunch break.
Oh, here’s an idea: allow doctors to be salaried, but fit them with collars that will deliver an an electric shock if they stop to chat with their office staff instead of rushing directly from one patient to the next.
Of course, the flip side of this is that doctors are not necessarily “more productive” when they are rushing from one patient to the next delivering substandard care to each in their frantic effort to maximize $$$. This is no doubt a big part of the reason our system is so much more prone to medical errors and malpractice than the nationalized systems are.The more time you spend getting the diagnosis right, the less money you make.
I don’t think too many people would be comfortable taking their car to a mechanic who rushed into the bay like a hyperventilating maniac, did a frantic once over on their car in less than 5 minutes, pronounced a tentative diagnosis, and then shoved you off to deal with the next customer in line, only to find out the diagnosis was wrong and you have to try something else next time…at your expense, of course. Why we put up with this from doctors, or think it desirable, is beyond me.
Perhaps we should go back to the piece work standard for all professions.Only make the pay contingent on successful outcomes.
re: “This is no doubt a big part of the reason our system is so much more prone to medical errors and malpractice than the nationalized systems are.’
Redhawk: Feel free to provide the source that provides evidence for that statement.
I work in a Dental office as a Chairside Assistant/Office Manager. The Dr. I work for is one of these lazy Drs. While he is here, he can produce and he does good work. BUT, getting him in here is usually the issue. He is contracted to work with area correctional facilities and spends most of his time working there. What am I left with? All day Tues, and Thurs afternoons. Which would be fine, EXCEPT it’s never a definite. I schedule appts and he has me cancel them last minute or even if I’m given enough time to move them around, it’s always the same people 3 or more times. I scratch my head at the fact that ALL of my patients don’t have me crying by the time I’m off the phone. Even if he is here, he will most of the time do the bare minimum. So instead of the patient coming in 2 or 3 times, they are coming 4-6. It sucks for everyone except him. He cares about no one except himself. It stinks because he’s really funny and nice, too laid back is the problem I suppose….. In any event, I’m looking for a new job, I’m sick of having to make myself look like an idiot.
Comments on this entry are closed.