Comments on: How Doctors Are Paid

By: Jay Montgomery

Jay Montgomery — Fri, 06 Apr 2007 19:27:59 +0000

No, Dr. Bob, paying physicians to make phone calls would be exactly the wrong thing to do. When we pay physicians to ‘do things’, thats what they do. And then they are not satisfied, so they ‘do more things’. The last I saw, 50% of patients were not taking their medications properly or at all. Paying for phone calls would surely dry up the last of those consceintious patients who call their doctor to ask questions pertinent to their health.

No, Dr. Bob, what we need to find ways to pay physicians for the costs they avoid by providing better care. That approach might encourage physicians to make that call to a recently diagnosed patient to make sure their questions are answered and that they are taking their medications properly. Phone calls like that just might strengthen the trust relationship with the physician and avoid unnecessary visits to ER/Urgent care.

If that sounds like a plug for P4P (pay for performance), it is not. P4P programs universally provide miserly small financial incentives when what we need are significant incentives that trigger that switch in the brain that begins to ask, “How can I reduce patient costs?” rather than “What do I have to do to increase revenues?” Important change will require that we do things differently if we are to do them better. And that almost always means new investment. Let’s offer physicians an investment opportunity where they invest their money to institute new care systems that will provide better (and therefore less costly) care.

By: Anonymous

Anonymous — Thu, 02 Nov 2006 14:25:07 +0000

I have been preaching this for years. Dr Anderson Hedberg, past Pres of ACP authored the seminal paper on the need for doctors to be reimbursed for phone consults, published in 2003. Reprints are available.

Dr. Bob Kramer

By: Michael C. Howe

Michael C. Howe — Tue, 31 Oct 2006 16:33:46 +0000

John Goodman once again offers us clarity and insight to the complicated challenges of improving our healthcare system. The accepted perspective is that our current healthcare system is broken and yet concise perspectives on the steps we have to take to correct it are difficult to find. In this most recent article from John, he offers excellent thoughts on what could and should be done; bringing consumer market forces to the delivery of healthcare will be a key element of high quality, affordable care.

Michael C. Howe, Chief Executive Officer
MinuteClinic