[Info] Healthcare

[epileric]

It seems Healthcare is a common issue here so I thought this aspect of healthcare would be interesting. This article discusses whether individual bonuses for doctors are a productive idea. It focuses on Canada but I don't think this issue is very different across borders and the article quotes relevant studies from all over.

You get what you pay for, right? It’s taken for granted that this holds true when it comes to using financial incentives to improve the quality of physician care. For example, if a GP gets a smoker to quit or a doctor at the hospital treats a heart-attack patient with the best medicine, they’ll be paid extra.

Intuitively, this makes sense: rewarding physicians for providing better care should, theoretically, boost quality and lead to improved health outcomes. That may be why “pay-for-performance” schemes have been touted by policymakers around the world. The Affordable Care Act in the U.S. advocates the use of pay-for-performance programs at hospitals. Britain and Australia have already ushered in these compensation models at the primary-care level. And here in Canada, health-care observers have long argued that rewarding and incenting quality among doctors is the way forward.

But what about the evidence?

Do doctor bonuses actually improve health care?

 

[Kaitybugsmom]

I've always been a supporter in people should be paid what they are worth. You have a good employee, they should be compensated as such. We own our own business and well, we pay ourselves. The way we pay ourselves is to offer the best work we can under all conditions. We have great customer service which keeps our customers coming back - thats our 'incentive bonus' pay. You do shotty work, you have no customers. Ok - fixing your $105k Audi A8, or your $80k MB isnt as important as fixing your heart or gallbladder. If we screw up...we can fix the mistake. Dr screws up...you might not be around to fix. In this scenario, who pays the bonus? If its the hospital, they should be paying the staff physician according to performance anyway. If the physician is self employeed (private practice) and they are good, they are getting that bonus anyway in referrals.

 

[epileric]

I found the article interesting in that they found most bonuses didn't work as well as acknowledgement. I never would have expected that.

“It wasn’t really pay per performance that seemed to drive the behavioural change,” Dr. Peabody continued, “but the measurement of performance.”

 

[Kaitybugsmom]

That surprised me as well. The one that really surprised me was that the one Dr. had only had one review of one patient in 30 years!

Does that mean that the rest were satisfied and only one had a complaint? If so, I would say thats pretty darn good.

I wonder just how often or how physicians are reviewed, by other than the patient.

 

[epileric]

That surprised me as well. The one that really surprised me was that the one Dr. had only had one review of one patient in 30 years!

Does that mean that the rest were satisfied and only one had a complaint? If so, I would say thats pretty darn good.

The way the author said "Unfortunately, doctors don’t seem to get performance reviews very often" I interpreted it to mean that she was referring to objective reviews of the persons medical practices & habits, not punitive reviews.

 

[Nakamova]

Knowing that someone is paying attention to what you do can make a huge difference. There have been studies where they put a surveillance camera in hospital washrooms, and hand-washing rates increase. Makes sense, right? But doctors will also improve their hand-washing if you just paint a big eye on the washroom wall. The mere sensation of being observed can put folks on their best behavior...