Wednesday, October 21, 2009
Is the evidence piling up everywhere or just around me?
First, there was the session advising primary care docs to start making money off MRIs. Then, there was a big TIME magazine article about the success of the Geisinger model. Now, today I attended a seminar on coordinated diabetes care, and heard over and over again--from docs and other experts--that the reason doctors don't do more care coordination is because they're not getting paid specifically for it.
One alternative to motivate coordination is to pay for outcomes, but of course, that brings up concerns about gaming the system and general fairness (as Zeke Emanuel put it, the reverse-Lake-Wobegone effect, where everyone thinks their patients are sicker than average).
It's beginning to seem more likely, to me at least, that doctors may have to be provided the same incentives that the rest of us are. Why do I write obits and answer phone calls from PR people instead of just crafting snide blog posts all day? Because it's my job and I'm paid a--here comes the dirty word--salary to do it. I know, the loss of independence and entrepreneurship and all that, but when more and more medical students are deciding that they don't want to get involved in the primary care business, maybe it's time to change the model.
Labels: health care reform, pay-for-performance
posted by Stacey Butterfield at
2:34 PM
ACP Internist hosted Grand Rounds on June 16, wrapping up the best of the medical blogosphere. Click here for the complete wrap-up.
Contact ACP Internist
Send comments to ACP Internist staff at acpinternist@acponline.org.
Previous Posts
- So that's what that slide does.
- QD: News Every Day--SGR cuts stalled
- QD: News Every Day--Senate considers SGR overhaul
- Narrowing the focus on fibromyalgia
- A rheumatology study for primary care
- The ACR's got milk...and lemonade and water.
- QD: News Every Day--the H1N1 fist bump
- Medical News of the Obvious
- QD: News Every Day--One stolen laptop threatens al...
- Patient uses Twitter as he undergoes appendectomy
Blog log
American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
Clinical Correlations
A collaborative medical blog started by Neil Shapiro, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.
db's Medical Rants
Robert M. Centor, FACP, contributes short essays contemplating medicine and the health care system.
Everything Health
EverythingHealth is designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
Getting Better with Dr. Val
Getting Better is the continuation of Dr. Val Jones' previous blog at Revolution Health. It is devoted to helping people understand health issues from a balanced, scientifically sound perspective.
HealthHombre
A roundup of health policy news drawn from a database of hundreds of Web sites.
Interact MD
Michael Benjamin, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
Kevin, MD
The alter ego of Kevin Pho, ACP Member, is the closest thing to royalty in the medical blog world.
LSUHSC-S Medical Library Evidence Alert
Major guidelines, systematic reviews, meta-analyses and/or major reviews by national and international organizations.
PLoS Blog
The Public Library of Science's open access materials include a blog.
White Coat Rants
One of the most popular anonymous blogs written by a doctor.
1 Comments:
Well, Ms. Butterfield, you certainly hit the nail on the head. I've said over and over...the primary care crisis would end in a heartbeat if the payment scale were raised. 10%?? No way. Pay them what they are worth to society...that means top pay. You would attract the best and the brightest! I've never known a first year med student who said "I want to do anesthesiology because I love gas and putting people to sleep".
Post a Comment
<< Home