Opinion
P4P not so simple a solution, proven by confusion over who gets the bonus
LETTER — Posted April 23, 2007
Regarding "Medicare pay-for-performance dilemma: Who gets the bonus?" (Article, April 2): I guess whoever is in charge of instituting pay-for-performance is beginning to get a taste of just how complicated medicine can be. Simplistic solutions, poorly thought out, are half measures that will delay needed reforms in health care delivery.
The longer this goes on, the more damage is done to the patient-doctor relationship, as doctors begin to look on difficult patients as liabilities.
I admit that I have been having such thoughts recently when confronted with the realities of pay-for-performance.
To top this off, the first chance primary care physicians have to equalize the enormous pay inequities in medicine, someone decides that primary care physicians are not really the primary providers.
Add to this the calculus of prospective versus retrospective methods of attribution -- well, I am not sure whether to laugh or cry.
All I can see coming from this is more distractions to the task at hand, which, if I remember, is taking care of patients.
Dean Raffaelli, DO, Chicago
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/04/23/edlt0423.htm.
