There is stable trend in the US to pay physicians based on their "productivity". That has become a word that elicits a reaction of nausea amongst many physicians these days. I find this among the worst ways a compensation plan could have been developed. It basically took the old "fee for service" plan and morphed it so that instead of directly getting dollars for your "work" you get a number attached to it - an "RVU". Hospital administrators then decide how much money to give you per RVU which then determines how much money you earn in any given year. So if you treat more patients you make more money. And by corollary, if you spend the exact same amount of time in a year with patients but see fewer and spend more time, you earn less money. See the problem?
Let me start by saying there is no "perfect system", at least that I know of. And I don't have all the answers. My area of expertise has never really been in healthcare administration. That said, it seems fairly obvious to me that the near national adoption of a system that pays doctors based on how many patients they can see in a day and how many surgeries they can perform during the year has some pretty obvious and potentially serious pitfalls. So much so that the only thing that should really surprise us is that there has not been more of an outcry against this system already.
If a doctor wants to bring home more money, he or she then needs to see more patients and/or operate on more patients. Let's all remember that doctors are also patients. I want what my patients want - for my doctor or surgeon to spend time with me, to explain things clearly, to make me feel comfortable with whatever decision is being made, etc. To the credit of my profession, I think that is still what happens most times ... but it is happening in spite of and not because of the system in place. And I'm sure there are instances where this is not always the case.
Of course I'm biased, but I think physicians should be well compensated. But compensation should come based on experience, patient care, value to the community and hospital you serve, etc. It should not be tied directly to squeezing in as many patients in a day as humanly possible. There's a big difference between quantity and quality of work. A physician that does a good job and takes great care of patients is a better physician than one who rushes through more patients in a day in a less thorough fashion. There are doctors who are supremely efficient and can see a high volume of patients AND do great work. Fantastic, pay them more. But those doctors should be obvious to any good healthcare system and they should simply have a higher base salary.
Healthcare, I think, is poised to undergo major changes legislatively over the next few decades. My hope is that whatever system is ultimately reached is one that pays physicians fairly and takes the emphasis off of how many people we treat. Pay a fair salary and get the focus back on quality of patient care instead of quantity.
Let me start by saying there is no "perfect system", at least that I know of. And I don't have all the answers. My area of expertise has never really been in healthcare administration. That said, it seems fairly obvious to me that the near national adoption of a system that pays doctors based on how many patients they can see in a day and how many surgeries they can perform during the year has some pretty obvious and potentially serious pitfalls. So much so that the only thing that should really surprise us is that there has not been more of an outcry against this system already.
If a doctor wants to bring home more money, he or she then needs to see more patients and/or operate on more patients. Let's all remember that doctors are also patients. I want what my patients want - for my doctor or surgeon to spend time with me, to explain things clearly, to make me feel comfortable with whatever decision is being made, etc. To the credit of my profession, I think that is still what happens most times ... but it is happening in spite of and not because of the system in place. And I'm sure there are instances where this is not always the case.
Of course I'm biased, but I think physicians should be well compensated. But compensation should come based on experience, patient care, value to the community and hospital you serve, etc. It should not be tied directly to squeezing in as many patients in a day as humanly possible. There's a big difference between quantity and quality of work. A physician that does a good job and takes great care of patients is a better physician than one who rushes through more patients in a day in a less thorough fashion. There are doctors who are supremely efficient and can see a high volume of patients AND do great work. Fantastic, pay them more. But those doctors should be obvious to any good healthcare system and they should simply have a higher base salary.
Healthcare, I think, is poised to undergo major changes legislatively over the next few decades. My hope is that whatever system is ultimately reached is one that pays physicians fairly and takes the emphasis off of how many people we treat. Pay a fair salary and get the focus back on quality of patient care instead of quantity.
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