AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. July 2013, Volume 15, Number 7.

Ethics Poll

Doctors’ Pay

The Ethics Poll is a snapshot of the opinions of interested readers.

Which of the following models of payment do you think would be most effective in promoting quality and safety in patient care?
Pay physicians for each procedure or task they perform (including talking with and educating patients).
Align physician pay with outcomes--that's what patients care about most.
Pay physicians for complying with practice standards, regardless of outcome; physicians cannot be held responsible for whether or not patients improve.
None of the above.
Don't know.

What do you think should be done to reduce the gap in pay between generalist and specialist physicians?
Nothing. Specialists have more education, training, and expertise.
Hospitals and multispecialty practice groups should agree about the value of the services their physicians offer and pay physicians based on the agreed value of services in patient outcomes (e.g., helping patients maintain cardiac health may be as valuable as the surgery patients get if they do not maintain cardiac health).
Hospitals and multispecialty practice groups should pay physicians for the nonprocedural activities (e.g., care coordination, phone calls, patient counseling) that primary care physicians spend more time on than specialists.
Don't know.

In a practice model known as concierge (or retainer) practice, patients pay the physician an annual sum (a retainer) in addition to payment for services. The physicians have fewer patients than other practices do, and, in return for the retainer, patients receive such benefits as same-day appointments, house calls, longer office visits, and accompaniment on visits to specialists. Some say that physicians who have concierge practices are not fulfilling their professionís pledge to care for all members of society who need medical attention. Do you agree?
Yes.
No.
Don't know.
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Poll results reflect the opinions of visitors to the site who voluntarily answer the poll questions. Those visitors do not represent a random sample of Virtual Mentor readers. The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.