New Poll Finds Physicians Very Wary of Bonus Pay Programs
TAMPA, Fla., Nov. 1, 2005 — Some physicians call them scams. Others see them as the only way to motivate doctors to improve the quality of patient care.
No matter how they view them, physicians are very wary of the growing number of pay-for-performance programs rocking U.S. health care. The programs pay bonus money to hospitals, clinics and individual physicians that meet certain benchmarks for good patient care.
A new national poll by the American College of Physician Executives (ACPE) found that nearly 40 percent of the 932 physician executives who took the poll are already participating in some sort of pay-for-performance program. Of the 53 percent who aren't yet involved in pay-for-performance – or P4P, as it's known – nearly 60 percent are considering it.
As one poll respondent put it, pay-for-performance programs "are an inevitable rising tsunami that will overtake us."
Bonus pay for taking better care of patients certainly is controversial.
"It is embarrassing to have to be paid to improve quality … our industry has been lax," one poll respondent wrote.
But a critic of bonus pay put it bluntly: Pay-for-performance programs "are the most recent scam to be perpetrated on physicians. Agree to them at your own peril. All physicians will regret their participation in any such program."
The physicians who are participating in pay-for-performance heartily agree (75 percent) that the programs reward physicians who meet performance goals, and a good many (60 percent) also say the programs encourage physicians to improve the quality of their patient care.
But when it comes to actually reducing the thousands of medical mistakes that haunt the U.S. health care system, fewer P4P participants (38 percent) believe the programs are making a difference.
And some feel that bonus pay has negative effects, such as causing rifts among physicians who achieve performance goals and those who don't (18 percent), and demoralizing physicians who fail to meet the goals (17 percent).
One of the most alarming concerns about pay-for-performance is the fear that doctors will avoid or refuse to treat patients in order to improve their overall scores and get the bonus money.
"There will be a dumping of non-compliant or difficult patients in order to have physicians performance appear good," one respondent predicted.
STORY ANGLE: Are doctors in your city involved in pay-for-performance programs? Use national survey results and local interviews to examine the impact of bonus pay in your community.
To obtain complete survey results and copies of the related articles contact Bill Steiger at ACPE at Email or 800-562-8088.