Shift Happens. Not

The article in the Wall Street Journal was called Medical Shift Fails to Cut Hospital Infections and once again it should be the smoking gun telling us not to turn to P4P/Quality Indicators.   For those who can’t read the article, here is a snippet:

A high-profile Medicare policy that sought to reduce certain hospital-acquired infections by cutting payments tied to treating them turned out to have no impact, according to a new study in the New England Journal of Medicine.

The study, which looked at the effect of the 2008 payment change on bloodstream and urinary-tract infections related to catheters, found “no evidence” that the shift had any measurable impact on the infections, which were already decreasing before the change went into effect. The study follows other research that has cast doubt on the effectiveness of some efforts to tie reimbursement to quality-improvement efforts in health care, an approach that is being considerably ramped up under the federal health overhaul.

Okay, people, this is not a Democrat or Republican issue.  This is not a liberal or conservative issue.  This is about evidence.  Pay-for-performance does NOT have the evidence to back it up.   And yet we physicians let others bull rush us with this crap and tie our pay to it.  Why?  I have been blogging about all the non-evidence for years and yet the AMA and the AAFP continue to buy into this farce.  Why?   Because we want to help patients and not seem like we are standing in the way. The funny thing, though, is now we will be hurting patients.  The only reason that Medicare and the managed care wants to move in this direction is because they see light at the end of the tunnel.  Better patient care? No.  What they see is a way to pay doctors less and have TOTAL control on how we treat our patients.   Everyone loses except them.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Shift Happens. Not

  1. mamadoc
    October 25, 2012 at 9:18 pm

    No, it’s a dumba$% issue. The AAFP and the AMA? Oh, please.

  2. Marco
    October 25, 2012 at 2:00 pm

    Contrary to the the general perception of burocratic stupidity, I’ll have to give the people in Washington credit for this.
    This is about saving money guys! I am sure that they already know that the measures will not increase “quality” (meaning less complications/better outcomes)as some studies have already suggested.
    This added to a system of reimbursement based on patient’s satisfaction from surveys, makes it not hard to imagine the kind of disaster we are heading to.
    Pretty soon we will envy those countries with “socialized” medicine.

  3. Pat
    October 22, 2012 at 3:07 pm

    Same reason I suppose, that all the college and NFL players are running around with various pink shoes, wrist bands, and other garments in October – as though saying “this looks stupid” would somehow equate to being PRO-breast cancer. All health care professionals – not you, CMS! – baaa’d along in their sheepish way, never demanding that the gov’t acknowledge that old folks can get UTI’s that are not provably iatrogenic.

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