Pay-for-performance plans will cause doctors to drop noncompliant patients

LETTER — Posted April 18, 2005

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Regarding "AMA: Medicare pay-for-performance must be voluntary and not punitive"(Article, March 21): Pay-for-performance would be a grave mistake for the American people. It is very conceivable that many people would lose access to medical care.

If this is enforced, then many noncompliant patients could be kicked out of a practice. There are many noncompliant patients for many different reasons, including not being able to afford optimum care. In a perfect world where every patient did everything exactly as they were told, then pay-for-performance would be effective. I feel that for these noncompliant patients, receiving some care is far better than no care -- and there are many of these patients.

Please consider this potentially disastrous consequence.

Daniel Richter, MD, Spencer, Iowa

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/04/18/edlt0418.htm.

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