Opinion

Don't penalize doctors for patient behavior that can't be controlled

LETTER — Posted Feb. 20, 2006

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Regarding "Pay-for-performance at odds with the idea of patient autonomy" (Letters, Jan. 16): I agree wholeheartedly with Christine Eady, DO, of Austin, Texas, regarding the fact that performance measures should take into account those aspects of medical care over which we physicians actually have control -- i.e., education and health maintenance and treatment recommendations. Physicians don't have the ability or authority to impose our recommendations onto our patients if they are unwilling to be compliant.

I would like to offer another option to improve patient care, and simultaneously reward physicians for appropriate recommendations. Insurance companies should pay physicians our fees instead of deleting the 99214 code from their reimbursement. If they wish, they may pay us a bonus for following health maintenance and treatment guidelines, while realizing this may cause an increase in the cost of caring for patients (such as ARBs for diabetic patients, colonoscopies, mammograms, etc.). I fear that in the future we will be penalized for increasing the cost of care by adhering to these recommendations.

Additionally, the insurance companies should assign significantly higher co-pays or deductibles to patients who do not follow through with documented physician recommendations regarding performance measures. This will give the physician the positive reinforcement for adhering to recommended guidelines, and give negative reinforcement to bad behavior -- just like raising a child.

David Kerner, DO, Fishkill, N.Y.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/02/20/edlt0220.htm.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn