Pauline Chen MD does a nice job in the NYT showing the problems with the current fad of physician profiling...ummm....I mean pay-for-performance programs. Here are some of the highlights:
- onerous administrative burden of collecting such large amounts of patient data
- worsening of clinician morale
- flawed evaluation criteria
She goes on to refer to a study which found many other problems. I recommend you check it out because our government has joined hands with the insurers and our hospitals to go all in on this crap. Here is what one investigator from the study said:
“When you shine a light on certain measures, you take away from others that are also important,” Dr. Hong said. “Fee-for-service has already driven physicians away from primary care. If we don’t address patient differences, we may do the same thing with pay-for-performance.”
As Mike Tyson said in The Hangover: "Nice".
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2 comments:
This is funny, when the notion of publicly grading or rating teachers is so controversial.
As a paramedic, I am paid on the basis of pay for performance. If I don't get a good evaluation from a boss who has been out of the field so long he can't remember what it's like to try to treat patients when it is your 24th call in 24 hours, (or who has never been in the field and doesn't care to be), I don't get a raise and can get demoted or fired.
Evaluations are pointless. They are seldom reflective of actual abilities, (some pts are going to keep getting sick or die regardless of how well I treat them); intensely political; subject to abuse; can be influenced by personal grudges; and directly related to the profit motive of the agency giving them, (we're not making enough money, so we will give you a bad evall so we don't have to give you a raise). Talk about destroying morale.
I think evals are a waste of time. They don't make better medics and they won't make better doctors.
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