Tuesday, December 25, 2007

ACP recent comments of P4P-sounds more like it but ...

I have not been one to sing the praises of the American College of Physicians and usually have offered my share of criticism. However, their recent comments which are critical of P4P , at least the way it seems to be playing out, appears to me to be more on target but unfortunately stops short of complete categorical condemnation which is what the concept deserves.

Here is a quote as found on a recent Medscape article which quotes from a recent piece in the Annals of Internal Medicine.

"Current incentives could result in deselection of patients, 'playing to the measures' rather than focusing on the patient as a whole, loss of trust between physicians and patients, unnecessary care, reduced access to care and continuity of care, and worse care for patients with complex chronic conditions. These consequences are avoidable, but only if the architects of the health care system try to avoid them."


I agree with all of the above except the comment about the consequences being avoidable. I believe paying or bribing doctors to do their job is a bad plan on its face and cannot be fixed by modifying this or that aspect of it. I find it a bit hard to reconcile these comments with the recent editorial in the Annals of Internal Medicine which urged physicians (and appealed to their professionalism) to work with insurers who strive to make medical practice lean and efficient.

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