Capitalism at its finest…
One way to encourage medical practitioners to improve themselves is to pay them more if they do. This is something that the government is intensely focused on. The concept of “pay for performance” has been kicked around for years. Recently the Centers for Medicare & Medicaid Services (CMS) initiated the Physician Quality Reporting Initiative (PQRI) as an attempt at doing just that. As a sort of “management based objective,” doctors that report certain information on Medicare patients can expect a higher percentage of compensation. This is absolutely a step in the right direction. Although I am curious about the effectiveness of this program in its current form. There are several issues preventing the expansion and subsequent improvement of this initiative. First of all, communication to doctors is notoriously a difficult task. Secondly, a growing number of doctors do not take Medicare patients, due to the low reimbursement. Finally, doctors are notoriously bad at record keeping. In fact they usually employ an often underpaid individual for this task. Counter-intuitive, right?
The good news is that as information technology becomes more integrated into private practices, this will become more widely adopted and expanded.
Labels: doctor, government, information technology, medical, Medicare, Physician, PQRI, reimbursement
Have you ever heard the joke: What do you call the guy who graduated last in his class at medical school? You call him “DOCTOR.” You probably don’t think that this is funny if you are the one that is about to be “cut on.” I don’t either. It’s amazing to me. Some of the largest expenditures that we encounter in life are healthcare related, and yet the tools available to the general public in order objectively assess the proficiency of a particular medical practitioner are extremely limited. Sure, there are a relative plethora of “review” websites, magazines, etc. touting ratings, but these are, at best, subjective opinions or, worse, marketing-driven. So how do you “rate” a doctor? Word-of-mouth recommendations by previous patients do have their place. However, studies have shown that patient experience is highly dependent on the “bed-side manner” of the doctor. I don’t know about you, but I would prefer a doctor with a “god complex” and has great outcomes rather than the doctor that makes me feel good when we talk and has poor outcomes. Referrals and recommendations from other medical practitioners are also inherently biased. I will address the Anatomy of the Referral in a later posting, STAY TUNED! Surely, there has to be an objective way to compare results. I can tell you that you and I are not the only ones who would like to know the answer to this question. In the capitalist society that we live, insurance companies are highly motivated to find the answer as well.
The question: How do you collect, maintain, and compare information about outcomes and then publish this information in a way that’s easy to understand? Another important question: How do you eliminate bias?
Can I get an Amen?
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