Should Popular Doctors Be Paid More?

January 18, 2012
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Starting in October 2012, Medicare will pay 3,000 acute care hospitals more based on higher client satisfaction survey results…

Starting in October 2012, Medicare will pay 3,000 acute care hospitals more based on higher client satisfaction survey results…

Client satisfaction surveys also affect many insurance company’s reimbursement rates for individual providers, are an accepted factor in many board-recertification processes, and are a planned future factor in doctor pay under Medicare, with implementation expected by 2015.

Whom do you think will get a higher patient satisfaction score and hence get paid more, the doctor who dashes off a Librium prescription after spending five minutes with [a patient], or the doctor who takes the time to try to explain the pitfalls, problems, and contraindications to him?

It’s hard to fathom how we got to the point where we actually pay popular people more for our healthcare.

No such system exists in any other professional or non-professional field. Not for lawyers, not architects, not nurses, not teachers. You can’t even pay your plumber less if she has a lower customer satisfaction score.

In client satisfaction surveys, 70 percent of practicing lawyers have very low satisfaction ratings. But we don’t pay less for our justice system, and I, for one, would argue strongly that we shouldn’t — at least not based on popularity.

There’s an even nastier, and more insidious, result from basing compensation on patient satisfaction. As Kevin Pho, writing as KevinMD, states, “Already, more than 80 percent of doctors, according to a survey from HealthLeaders Media earlier this year, said patient pressure influenced their medical decisions. And in primary care, linking bonus pay to patient satisfaction could cause physicians to be more selective in who they see, subtly keeping patients who they know will score them well, and referring disagreeable ones to other providers.”

Full post on paying popular physicians more for their services.