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

Should health care come with a money-back guarantee?

Michael Kirsch, MD
Physician
October 16, 2019
119 Shares
Share
Tweet
Share

It may seem odd that a gastroenterologist patronizes fast food establishments several times each week. I’m in one right now as I write this. I eschew the food items –though French fries will forever tempt me – and opt for a large-sized beverage. In truth, I am not primarily there for a thirst-quenching experience, but more to ‘rent a table’ so I can bury myself in some reading. Indeed, many thousands of New York Times issues have been devoured at these tables. I saw a sign posted on the wall here that I had not seen before.

Refunds? How often can this happen in a place like this? We all know that food items in these institutions are remarkably consistent, which is one of the benefits that customers enjoy. Your Big Mac or Whopper will taste the same in Pittsburgh as it does in Peoria. I questioned the server on this new development, and she explained that increasingly customers were demanding refunds for contrived reasons in an effort to bilk the restaurant. At some point, the restaurant decided to put an end to this practice.

I wonder how my patients would react to being greeted by such a sign in my office? Of course, physicians do not offer refunds, or a money-back guarantee for our services, as other industries boast. Nearly every infomercial includes the tag, “and if you don’t agree that these _____ are the best you’ve ever used, simply return it for a full refund — no questions asked!” Not so in the medical profession. We are paid regardless of the outcome or your satisfaction. It is true that physician reimbursement policy is evolving away from fee-for-service (FFS) toward a value-based system. In other words, physicians won’t be paid separately for every medical service we provide you, but for the overall “value” we provide, which is a somewhat amorphous concept. FFS clearly incentivizes the medical profession to overtreat patients because we are paid more for doing more, even if such care may not be truly necessary. It remains to be seen if the value-based payment approach will protect patients and be fair to physicians. I have my doubts.

Many professionals are paid regardless of how their clients fare. If you lose your case in court, your lawyer will still be paid. If a judge is overruled on appeal, his wages aren’t reduced. If your investment underperforms, your financial planner doesn’t return his fee to you. Tradesmen, on the other hand, make a commitment to satisfy us as a condition for getting paid. If we hire a plumber to unclog a sink, for example, he understands that if he doesn’t deliver, then we won’t either.

What if all of us were paid on results rather than on time expended? Would this lead to higher quality goods and services? Could it really apply to the medical profession? If a patient comes to see me with abdominal pain, which often defies explanation even after a thorough medical evaluation, is it fair that I wouldn’t be paid if the patient’s pain persists?

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Image credit: Shutterstock.com

Prev

How do you determine that the dream of medicine is worth it?

October 16, 2019 Kevin 0
…
Next

Denial and rationalization will not save you from a heart attack

October 16, 2019 Kevin 1
…

Tagged as: Gastroenterology, Hospital-Based Medicine

Post navigation

< Previous Post
How do you determine that the dream of medicine is worth it?
Next Post >
Denial and rationalization will not save you from a heart attack

More by Michael Kirsch, MD

  • Drawing the line on unnecessary medical tests

    Michael Kirsch, MD
  • We are suffering from an epidemic of anger

    Michael Kirsch, MD
  • Physicians sometimes need to deviate from established policies

    Michael Kirsch, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why health care replaced physician care

    Michael Weiss, MD
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Health care needs more physician CEOs

    Alexi Nazem, MD
  • Money will be lost in health care. This is true no matter how we describe it.

    Edwin Leap, MD
  • Health care is not a service commodity

    Peter Spence, MD, MBA

More in Physician

  • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

    Marie Livesey, DO
  • Heartwarming stories of cancer patients teaching us about life and the human spirit

    Johnathan Yao, MD, MPH
  • We need a new Hippocratic Oath that puts patient autonomy first

    Jeffrey A. Singer, MD
  • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

    Ton La, Jr., MD, JD
  • How can there be joy in medicine if there is no joy in Mudville?

    Arthur Lazarus, MD, MBA
  • Physician entrepreneurs offer hope for burned out doctors

    Cindy Rubin, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

      Marie Livesey, DO | Physician
    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | 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 2 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

  • Psoriasis Biosimilars Appear to Match Up to Original Products, With Caveats
  • Are New Dads More Likely to Need Antidepressants?
  • Getting Inspired to Do More
  • Missing Doctor's Body Found; Ketamine for Migraines; Foodborne Illness Outbreaks
  • Catching the Optimal Amount of Z's May Be Protective Against Long COVID

Meeting Coverage

  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • The Role of Amyloid PET in the Management of Alzheimer's Disease
  • New Inflammation Inhibitor Proves Effective and Safe for Dry Eye Disease
  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

      Marie Livesey, DO | Physician
    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | 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

Should health care come with a money-back guarantee?
2 comments

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

Loading Comments...