By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    superfoods to help with prostate health
    10 Healthy Foods That Can Help Protect Your Prostate
    August 29, 2022
    recover from an acl injury
    Best Exercises to Rehab a Torn ACL Without Special Equipment
    November 29, 2022
    medical practice and technology advancement
    6 Essential Strategies for Improving Your Medical Practice
    January 25, 2023
    Latest News
    7 Most Common Healthcare Accreditation Programs: Which Should You Use?
    August 20, 2025
    Hospital Pest Control and the Fight Against Superbugs
    August 20, 2025
    Hygiene Beyond The Clinic: Attention To Overlooked Non-Clinical Spaces
    August 13, 2025
    5 Steps to a Promising Career as a Healthcare Administrator
    August 3, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Heart Attacks & Hospitalization in CA
    June 16, 2011
    1309953786_9781780660004-web_w185_h300
    Possibly the Best #Health Advice You Could Get!
    March 2, 2012
    Is a Government Takeover of Health Care Underway?
    August 1, 2011
    Latest News
    How Social Security Disability Shapes Access to Care and Everyday Health
    August 22, 2025
    How a DUI Lawyer Can Help When Your Future Health Feels Uncertain
    August 22, 2025
    How One Fall Can Lead to a Long Road of Medical Complications
    August 22, 2025
    How IT and Marketing Teams Can Collaborate to Protect Patient Trust
    July 17, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Fee-for-Service Again
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Finance > Fee-for-Service Again
BusinessFinanceHospital AdministrationPolicy & Law

Fee-for-Service Again

Greg Scandlen
Greg Scandlen
Share
5 Min Read
Fee-for-service care
SHARE

Fee-for-service careUSA Today asked me to write a counterpoint to their editorial calling for the abolition of Fee-For-Service payment in health care.

Fee-for-service careUSA Today asked me to write a counterpoint to their editorial calling for the abolition of Fee-For-Service payment in health care. Their editorial is here, and my counter is here.

Unfortunately, USA Today did not show me the article I was responding to. Now that I have read it, I want to make a few other observations.

First, the paper thinks that putting physicians on salary would curb the problem of overtreatment. Yes, it might do that, and replace one problem with another — under treatment. Physicians might become clock-watchers, punching in at 9:00 and out at 5:00, regardless of patient need. While on the clock, they might slow-walk their services. After all, why hurry when you get the same pay regardless of how much work you do? Even factories have long figured this one out, preferring to pay piecework instead of flat wages.

More Read

The Tips Of Staying Safe In Healthcare: A Helpful Guide
A 12-Point Checklist For Healthcare Web Content Management
How to Align Your Hospital Marketing Plan with Your Business Objectives
InCrowd Joins the Healthcare Social Media Discussion
Here’s Why Plastic Surgery Shouldn’t Be Taboo Anymore

But USA Today sees a more insidious problem in health care. It believes some physicians are “greedy, incompetent, and crooked.” No doubt that is true. I expect some newspaper editors are also “greedy, incompetent, and crooked.” Does placing doctors on salary solve that problem? No, it would actually worsen it for at least a couple of reasons. First, the physician would no longer be responsible for securing and paying for his own malpractice insurance. He would be covered by an enterprise-wide policy that minimizes his own culpability. Second, greedy, incompetent and crooked employees are very good at hiding in a big bureaucracy. They can always find someone else to blame for their own misdeeds and be shielded by workplace rules. Have you noticed how hard it has been to fire Lois Lerner from the IRS?

The paper says, “Ideally, doctors do no more than a patient needs.” Well, yes. But it is often hard to tell in advance what is “more than a patient needs,” and if doing “no more than needed” is the imperative, we might often end up doing less than the patient needs, with tragic consequences. If we place a ceiling on what the doctor does, if we punish him for doing more, he may err on the side of caution and often do less.

The paper also wants us to “encourage second opinions.” Good grief. Getting second opinions has been touted as a panacea for at least the last 30 years. Most of the research I have seen says that the second opinion almost always confirms the first opinion, but adds to costs because the second opinion is not cheap. That does not mean second opinions shouldn’t be done. Individual patients will be comforted if the first is confirmed or may change her mind if it is counter to the first. But there is no guarantee that the second opinion will be more valid than the first, and if the two conflict it may be necessary to get a third.

Finally, the paper says something I can agree with –

…[O]ne of the most effective ways to cut down on unnecessary operations is for doctors to share the decision-making with their patients by pointing out alternatives…

Yes, indeed. But it helps if the patient is holding the checkbook during that conversation. That is the only equalizer the patient has when negotiating with the doctor. The doctor can explain the advantages and disadvantages of each alternative, and what the costs will be! And the patient can then make a fully-informed decision. But that implies something USA Today has been railing against — a system in which fees reflect the services provided.  Otherwise, in a salaried system, the doctor will be advocating for the easiest, cheapest alternative and the patient will be suspicious of the recommendation and push for the most complicated and costly choice.

There is simply no substitute for a fee-for-service system in which the patient pays.

(Fee-for-service care / shutterstock)

TAGGED:fee for service
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

travel nurse in north carolina
Balancing Speed and Scope: Choosing the Nursing Degree That Fits Your Goals
Nursing
September 1, 2025
intimacy
How to Keep Intimacy Comfortable as You Age
Relationship and Lifestyle Senior Care
September 1, 2025
engineer fitting prosthetic arm
How Social Security Disability Shapes Access to Care and Everyday Health
Health care
August 20, 2025
a woman explaining the document
How a DUI Lawyer Can Help When Your Future Health Feels Uncertain
Public Health
August 20, 2025

You Might also Like

willing provider
BusinessPolicy & Law

The Willing Provider Problem

July 17, 2013
Health carePublic Health

The Link Between Sustainability And Health

August 9, 2020
Health careMedical Innovations

These Advances In Healthcare Technology Are Changing The Industry

April 15, 2019
Health care

What Does Medicare Cost in 2022?

May 18, 2022
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?