Survey finds many doctors prefer being paid a salary instead of per volume

Doctor pocketing cash
Many doctors prefer being paid a salary, a new study shows.

While the country shifts to value-based care, a national survey found many doctors would actually prefer being paid a salary.

The survey of 450 physicians by the Texas Medical Center Health Policy Institute in Houston found that 69% of doctors said their preferred way of being paid would be with a high proportion of their compensation as salary—with a low proportion of their pay based on incentives—or a straight salary with no incentives.

Paying doctors a salary, instead of with a fee-for-service system, could also be a way for the healthcare system to cut costs by eliminating the overtreatment of patients, Arthur “Tim” Garson, Jr., M.D., director of the Institute, told FierceHealthcare. “The data bears this out,” he said, since studies suggest that the number of tests and procedures performed will decrease if more doctors were salaried.

Arthur "Tim" Garson
Arthur "Tim" Garson, Jr..

That’s critical since it is estimated that nearly $200 billion per year is spent on overtreatment, he said. If more doctors were paid a salary, there wouldn’t be the stimulus to order more procedures and tests under a system of incentive pay based on the volume of care they provide.

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Some major providers such as Mayo Clinic, Cleveland Clinic and Kaiser Permanente have found success in switching to a straight salary system.

The survey also found that doctors and patients are on the same page when it comes to the unaffordability of healthcare and the reasons for those rising costs. The survey, which included more than 9,000 consumers in 15 states (including five "red," five "blue" and five swing states), found both patients and physicians blame insurance companies, drug companies and medical device manufacturers for rising healthcare costs.

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They also agree that the most effective ways to reduce those costs are to increase costs of insurance for people with poor health habits and for insurers to offer affordable catastrophic health insurance plans, the survey found.

Garson said one factor that surprised him from the survey findings was consumers’ view of what is affordable healthcare, which is vastly different from lawmakers’ view of affordability. The majority of uninsured respondents, regardless of income, said they consider spending 2% of their income on healthcare to be affordable. The Affordable Care Act, on the other hand, defines coverage as “affordable” if it doesn’t cost more than 8.2% of a person’s income.