Performance pay plans will increase paperwork burden for physicians

LETTER — Posted April 17, 2006

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As I see it, pay-for-performance is another way to penalize primary care physicians who practice in the most difficult circumstances -- in underserved communities with the sickest patients who have the least resources. I see it as another way nonphysicians are making demands on us without any idea of the realities of a clinical practice.

I see it as more nonproductive and, you can be sure, noncompensated paperwork. The idea of shifting through hundreds of records to mine data so some entity can have another reason to deny payment for my services is revolting.

Most of my visits with patients are spent filling out forms. Recently I have noted the abuse of the four-page Family Medical Leave Act forms for trivial complaints, the proliferation of HMO referral forms in triplicate and unrealistic demands for $6,000 motorized vehicles.

I think it is time we just say no. If we do not, I fear this is only the beginning of being dictated to by insurers, lawyers, MBAs and the government.

Dean Raffaelli, DO, Chicago

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/04/17/edlt0417.htm.

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