Focus on physician income misses the point


This month, two studies on physician compensation came out. One suggested that doctors' income was going up slowly because it wasn't beating inflation; another noted that physician compensation grew last year in spite of the sick economy. In my mind, though, neither is that interesting. After all, is focusing on how much doctors were paid--rather than what they were paid for--really the way we want to go? 

True, compensation figures tell you something about how productive that doctor was, and possibly, how good they are at bringing operating costs to heel. The thing is, to my knowledge neither of these measures say anything about which procedures were being rewarded and which were discouraged; whether physicians were being paid to provide the right kinds of service and spend time with the patient; and whether physicians were up to date on evidence-based care.

Of course, these aren't new ideas. Over the last few years, pay-for-performance models have attempted to address all of these concerns, particularly the issue of whether physicians were hitting all their marks in terms of prevention and maintenance of chronically-ill patients.

Also, much of the discussion around "medical home" models centers on how payment models should be shifted to better encourage closer management of patients and better coordination with specialists.

The thing is, as long as consultants and professional organizations are focused primarily on the net compensation to the physician, they're doing their members a disservice. Yes, income is a bread-and-butter issue for everybody, and doctors are entitled to be as aware of what they're being paid--and whether that pay is fair--as professionals in any other industry.

But if they want to be in synch with industry trends, and what's more, get prepared for where reimbursement models are going, it's probably helpful for doctors to begin thinking differently about pay. Don't wait for insurance companies to decide that you deserve a good income for quality; get ahead of that issue. Why wait until you don't have a say? - Anne

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