The administrators in charge of employing doctors (along with the insurers) are running our healthcare system. And of course, they must know best. A recent American Medical News article details how:
- Growth in employment contracts also reflected physicians’ move away from independent practice.
- 57% of physicians worked in independent practice in 2000. That proportion was about 39% by 2012. Accenture predicted that 36% of doctors would be independent by the end of 2013.
- Doctors cited the cost of running practices and medical record requirements as reasons to opt for employment with hospitals and groups.
- Employers are stressing certain attributes for doctors in incentive plans, shifting more heavily toward quality of care rather than the number of patients physicians see
- 77% of surveyed organizations saying they used quality as a primary metric, and 66% using patient satisfaction to determine incentive packages. That compares with 39% that used outcomes as a performance metric.
Here is the problem with what employers are doing. Sure it sounds idealistic to say that quality of care is more important than the number of patients a doctors see. They paint a picture of doctors not caring about their job and just churning through patients like cattle. Well, not fitting in and seeing those little kids with acute ear infections or the little old ladies with the flu may not affect their scores but it sure isn’t great care. Interestingly enough, they have NEVER defined what quality of care means. Ask teachers who have to teach to the test. When a doctor just tries to meet metrics (and ignores non-metric issues like depression, acute care issues, etc) does that mean she is doing a great job? And look at that last highlight above. Paying incentives on quality and patient satisfaction has also NEVER been proven in large studies to improve patient care!
And yet we let these idiots run our healthcare system? Why? Because like strippers, we physicians are too afraid to “get off the pole”.