Opinion

Pay-for-performance must take into account patient compliance

LETTER — Posted Aug. 8, 2005

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Regarding the numerous articles about pay-for-performance initiatives in AMNews and other journals, one area that has been neglected in the debate is patient compliance. It is unfair to penalize doctors for not reaching benchmarks when their patients do not follow through on recommendations. I believe that doctors meet requirements at the moment that they order the recommended test, not when the patient complies.

Why do we continue to coddle patients who refuse to follow our recommendations, then allow insurance companies and others to penalize us when patients don't follow through?

If pay-for-performance does not take patient compliance into account, then doctors will have to choose to dismiss these noncompliant patients from their practices or face losing dollars or other incentives, which may leave some patients without care.

Christine M. Eady, DO, Austin, Texas

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/08/08/edlt0808.htm.

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