Here is a reform idea borrowed from the agricultural subsidies program:
Every American medical community has physicians whose typical utilization patterns exceed the average for their specialty by more than two standard deviations….
Physician Fallow would offer the identified doctors a generous stipend not to practice medicine or surgery for several years. In exchange for the promise to do nothing medically related, fallow physicians’ pay could be set generously, say, at 75 percent or even 100 percent of the average of their last three years’ income.
The quality, safety and cost benefit from taking these super-utilizer physicians out of commission would be immediate and huge. Millions of patients would avoid unnecessary procedures, escaping risk of serious harm or even death, and saving money for purchasers. Complication rates and hospital deaths would plummet. Physician Fallow would produce better, safer care without health plans telling doctors how to practice medicine. It would simply reduce the number of physicians clearly practicing non-evidence-based medicine and surgery.
Here’s what I see as the major problem: Wouldn’t all doctors have an economic incentive to become high utilizers?
Full article on David Kibbe and Brian Keppler’s Physician Fallow.