Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

There is no billing code for compassion

Paul Levy
Patient
August 7, 2011
770 Shares
Share
Tweet
Share

Back in 2009, Dr. Amy Ship gave a moving acceptance speech when she received the annual Compassionate Caregiver Award from the Schwartz Center.

The most memorable tag line from the speech was, “There is no billing code for compassion.” This resonated with so many of us — patients and providers — in part because it set forth the proposition that compassionate care should be an inherent aspect of medical services. The idea that some portion of a doctor’s or hospital’s payment should be tied to such an essential human value seemed ludicrous.

Or is it? A recent survey conducted by the Schwartz Center, entitled “The state of compassionate care in the United States,” indirectly raises the issue. Those patients and doctors surveyed were overwhelmingly in favor of the idea that compassionate care was important to the successful treatment of patients. They agreed, too, that compassionate care makes a difference in how well a patient recovers from illness. Indeed, they believed that good communication and emotional support can make a difference in whether a patient lives or dies.

But there was a gap between what patients said was most important to them, in terms of compassionate care, and what they actually experienced during recent hospitalizations. And, looking forward, both patients and doctors are worried that the changes being made in our health care system will make it more difficult for providers to offer compassionate care.

Now, if we remove the word “compassionate” from the above discussion and instead insert “safety,” “quality,” “avoiding hospital acquired infections,” or the like, our immediate response would be that we need to change the system of hospital and physician payments to provide financial incentives to change things for the better. Whether we might propose a pay-for-performance approach or some kind of global payment to encourage improvement, the current environment seems very comfortable with using the payment system to nudge behavior in the right direction.

So, why not pay for compassion? Surely, we can name those aspects of care that are most closely tied to compassion, and we can likewise document whether they occur.

While I will let this debate play out in the comments below, let me start it off by saying that I believe this would be a mistake. So many discrete aspects of medical care are already monetized that is hard to imagine a payment regime that would actually focus sufficient financial attention to motivate a doctor along the spectrum of less-to-more compassion. Beyond that, the idealist in me is offended by the idea of paying someone to, in essence, be more humane. In my view, this is not a matter of remuneration. It is a matter of societal values and a training program and ongoing supervision that imbues practice with those values.

But, let’s hear what you have to say. Should there be a billing code for compassionate care?

Paul Levy is the former President and CEO of Beth Israel Deaconess Medical Center in Boston and blogs at Not Running a Hospital. He is the author of Goal Play!: Leadership Lessons from the Soccer Field and How a Blog Held Off the Most Powerful Union in America.

Prev

A cream to fight obesity is being ignored

August 7, 2011 Kevin 2
…
Next

Using RFID tags to track physician movement at conferences

August 7, 2011 Kevin 3
…

Tagged as: Hospital-Based Medicine, Patients

Post navigation

< Previous Post
A cream to fight obesity is being ignored
Next Post >
Using RFID tags to track physician movement at conferences

More by Paul Levy

  • a desk with keyboard and ipad with the kevinmd logo

    Health care networks: A mistake we will pay for

    Paul Levy
  • How to protect physicians from themselves

    Paul Levy
  • The triple aim has been hijacked by powerful political forces

    Paul Levy

More in Patient

  • AI’s role in streamlining colorectal cancer screening [PODCAST]

    The Podcast by KevinMD
  • There’s no one to drive your patient home

    Denise Reich
  • Dying is a selfish business

    Nancie Wiseman Attwater
  • A story of a good death

    Carol Ewig
  • We are warriors: doctors and patients

    Michele Luckenbaugh
  • Patient care is not a spectator sport

    Jim Sholler
  • Most Popular

  • Past Week

    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Unraveling the mysteries of mast cell disorders [PODCAST]

      The Podcast by KevinMD | Podcast
    • Coping with grief in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Navigating physician shortages in rural communities

      Stacy Wentworth, MD | Physician
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
    • When medical protocol meets family concerns

      Richard Young, MD | Conditions
  • Recent Posts

    • Unraveling the mysteries of mast cell disorders [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to select the right mutual funds for your goals

      Amarish Dave, DO | Finance
    • America’s pain management nightmare: How the DEA shaped the opioid epidemic

      L. Joseph Parker, MD | Physician
    • The middleman dilemma in health care

      Anonymous | Physician
    • Tips for success as a plastic surgeon [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why write? Physicians share their stories of healing through writing.

      Kim Downey, PT | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 12 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • ASCT Tops CAR T-Cell Therapy for Relapsed LBCL in Complete Remission
  • 'New Gold Standard' for Previously Untreated CLL
  • Emicizumab Safe, Effective, in Infants With Hemophilia A
  • Add-On Inavolisib Ups PFS in PIK3CA-Mutated Breast Cancer
  • Lovo-Cel 'Life-Changing, Transformative' in Sickle Cell Disease

Meeting Coverage

  • ASCT Tops CAR T-Cell Therapy for Relapsed LBCL in Complete Remission
  • 'New Gold Standard' for Previously Untreated CLL
  • Emicizumab Safe, Effective, in Infants With Hemophilia A
  • Add-On Inavolisib Ups PFS in PIK3CA-Mutated Breast Cancer
  • Lovo-Cel 'Life-Changing, Transformative' in Sickle Cell Disease
  • Most Popular

  • Past Week

    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • The dark role of science, medicine, and tasers

      L. Joseph Parker, MD | Physician
    • The synergy of AI and human intelligence in transforming health care

      Harvey Castro, MD, MBA | Tech
    • Unraveling the mysteries of mast cell disorders [PODCAST]

      The Podcast by KevinMD | Podcast
    • Coping with grief in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Navigating physician shortages in rural communities

      Stacy Wentworth, MD | Physician
  • Past 6 Months

    • Medicare coverage saves lives. Enrolling shouldn’t be this complicated.

      Catherine L. Chen, MD, MPH | Physician
    • Emergency department burnout: a cry for change

      Anonymous | Conditions
    • The erosion of compassion in medicine

      Daniel Luger, MD | Education
    • Health care’s hidden problem: hospital primary care losses

      Christopher Habig, MBA | Policy
    • Pain medicine realities: beyond the opioid crisis

      Richard A. Lawhern, PhD and Stephen E. Nadeau, MD | Conditions
    • When medical protocol meets family concerns

      Richard Young, MD | Conditions
  • Recent Posts

    • Unraveling the mysteries of mast cell disorders [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to select the right mutual funds for your goals

      Amarish Dave, DO | Finance
    • America’s pain management nightmare: How the DEA shaped the opioid epidemic

      L. Joseph Parker, MD | Physician
    • The middleman dilemma in health care

      Anonymous | Physician
    • Tips for success as a plastic surgeon [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why write? Physicians share their stories of healing through writing.

      Kim Downey, PT | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

There is no billing code for compassion
12 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...