Blog | Monday, April 29, 2013

A call for physician payment reform


Readers know that I dislike the current fee-for-service model, because it encourages volume throughput. A new commission agrees: To contain health care costs, pay doctors differently.

We cannot control runaway medical spending without changing how physicians in this country are paid, which is currently the single most significant driver of health care costs. We pay physicians according to the number of services they provide. The skewed financial incentives inherent in a fee-for-service model promote fragmented care and encourage doctors to provide more--and more costly--care, regardless as to whether those services improve the health of patients.

The best way to improve health care is to change payment models to promote primary care and better care co-ordination. Some will not like this approach because with any payment change there are winners and losers. We should focus on the most important winners: patient care and spending.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Associate Dean for the Huntsville Regional Medical Campus of UASOM. He also serves as a frequent ward attending at the Birmingham VA Hospital. This post originally appeared at his blog, db's Medical Rants.