November 7, 2007
Arnold Kling
The New York Times reports,
An influential medical standards group plans to present a new model today for helping employers and insurers to identify the best primary care doctors and to steer patients their way. Those doctors, in turn, would be paid for more services than are currently reimbursed under typical health plan payments for office visits.
The idea is to encourage doctors to meet with patients for more than a few minutes during an office visit and to also compensate them, or nurse coordinators, for communicating with patients by phone and e-mail outside office hours.
The organization,
National Center for Quality Assessment, does not seem to place much weight on statistical evidence. To me, that is something of a red flag.
Thanks to Joseph Coletti for the pointer.
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When I first read it, I thought they were trying to match patients with primary care physicians that were best suited to them, either because of experience or personality. Wouldn't it make more sense to reduce the amount of patients those doctors see, in order to increase the amount of time spent with the patient? It seems like the program itself is contradictory—more patients and more time with patients. Didn't the doc choose GP because they don't want to spend all their time working?
Great plan. Now you have a few of the really good docs in one field spending inordinate time talking to patients and making them feel 'wanted', 'needed', 'appreciated' etc (try a friend people, not your physician...it doesn't take 7+ years of postgraduate training to train someone to listen to grandma, who'll talk all day about her last BM if you let her) instead of performing beneficial doctorly activities like, oh...say, actually making medical decisions or treating patients.
And in response to 8, "Didn't the doc choose GP because they don't want to spend all their time working?" Some are talented and like the challenge of primary care, but the majority are just students from the bottom of their medical school classes who couldn't get into anything else, or foreign docs looking for any chance to get a foot in the door in the US.
"The organization, National Center for Quality Assessment, does not seem to place much weight on statistical evidence."
Arnold, which statistical evidence do you have in mind? Can someone point me to it?
there is nothing new in this effort to identify the best doctors. On close inspection the criteria used do not hold up. Indeed, what are the criteria? This august body of physicians and other self styled authorities have created a body with the power to do much mischief to the medical community with their good intentions and arrogance. Beware those who think they know it all and what is best for us.
