Comments on: "The way we pay physicians encourages waiting"

By: Anonymous

Anonymous — Mon, 27 Aug 2007 01:21:00 +0000

How exactly can the patients, most of whom have no say in the negotiation between their employer and their health insurer, nor their physician and the health insurer, do anything about this?

It’s up to the physicians. The people who get paid.

By: Anonymous

Anonymous — Sat, 25 Aug 2007 04:47:00 +0000

“What is your incentive to care that much about wait times?”
I should have explained. I work in a group practice. The group has decided that it values “patient satisfaction.” Most of my salary depends on the RVU’s that I generate. However, a percentage of my pay is dependent on my contribution to the good of the group, and to “patient satisfaction” measures. Our timeliness is easy to measure, and it’s important to patients. Ergo, it goes into our salary equation, among other things.

Mostly it means that I can’t just show up whenever I want, and make pts wait without an extremely good reason (which is imparted to waiting patients by me, or by staff). If I’m late because I’m busy intubating someone, I get a special dispensation, thank God.

By: Greg P

Greg P — Sat, 25 Aug 2007 03:03:00 +0000

I do everything I can to try to stay on time. The key issues are self-discipline and realism, coupled with caring about the patient's time.

Any doctor who runs 30, 60, or more minutes late day after day is totally out of touch with reality and presumably unhappy, unfortunately taking it out on his patients.

But it works the other way too. If a patient shows up late, I tell them they will have to wait for me to work them in around the patients who did show up on time, or they may have to reschedule.

By: Anonymous

Anonymous — Fri, 24 Aug 2007 21:35:00 +0000

Why? What is your incentive to care that much about wait times? I can understand the desire to minimize them, certainly, but for a group (as opposed to hospital employee situation) it seems odd to make them that big a deal. I suppose if you are in an oversaturated field where you actually have to compete for new patients, perhaps, but that’s hardly the boat most are in. Rather, it’s how to get all the patients into one day.

By: Anonymous

Anonymous — Fri, 24 Aug 2007 18:36:00 +0000

I think it should say, “as long as we are paid per visit rather than for being on time.” In my group practice, doctors’ timeliness is taken seriously. Waiting times are tracked by our staff, and forwarded to management. Patients are asked to fill out questionnaires about their waiting times. This data is assessed during my performance review.

By: Anonymous

Anonymous — Fri, 24 Aug 2007 16:43:00 +0000

"As long as we are paid per visit rather than for our time, we will have this problem."

Another conclusion that isn't supported by the facts. What is assumed is that insurance companies will pay more to doctors if they pay by the hour. That is total BS. The insurance companies don't really care about procedure vs. hourly billing--they only care about paying as little as possible. The only way doctors will get to spend more time with patients is if doctors get paid more, not whether they are paid by the hour.

Another article credulously forwarded by Kevin without thinking about it.

By: Anonymous

Anonymous — Fri, 24 Aug 2007 16:27:00 +0000

If you are paid by time that will equal less patients seen in a day. There is no way around that. Less patients seen means a longer time until you get your appointment. I’d rather expect to wait at an office than wait extra days or weeks for an appointment.