Merrill Goozner: “The more important reform is that physicians be organized into group practices that encompassed all the necessary specialties. And they should be paid not by the number of patients they see or can run through their individual offices, but by skill, experience and their relative importance to improving patients’ overall health.”
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Exactly how are they going to convince “overcompensated” radiologists and surgeons to join these clinics, where their earnings would not go to them but to subsidize lower paid docs? If they are “forced” into such a system, it would take a generation to get to where you don’t have any surgeons. Why should anyone go through 5-7 years of rigorous post-MD training to subsidize someone who did 3 years? The graduated income tax is bad enough.
Where have these people been. It has been done over and over. Many of the large multispecialty clinics, including the one I used to work for, went to capitation in the early nineties and stopped paying people on productivity. In fact the ones who thrives were the anti-productive.
It, of course, fell apart for a variety of reasons, ditched capitation, and went back to productivity based compensation but with productivity measured by RVS.
Which with it’s distotions of market price, means that they can’t keep certain specialists at all who find that the market place values their service far more than that committee. All the plastic surgeons and shrinks are long gone.
Socialist blather. You cannot rule by committee. I would be paid millions of dollars per year if I was paid the economic value of my product.
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