Variations among physicians in diagnosis and X-ray interpretation, the percentages of which have remained essentially unchanged for five decades, raise serious ethical concerns.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
Physicians need to be aware of and guard against the liability risks of having nonphysician clinicians provide services that do not meet the standard of care of the practice due to the staff member's inadequate experience or supervision.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
Drs Lynne Fehrenbacher and Leah Leonard-Kandarapally join Ethics Talk to discuss key roles of infectious disease pharmacists in antimicrobial stewardship.
The objective is to compare the costs of providing the same level of quality. When resource-use and quality measures are juxtaposed, the resources used to provide the same level of quality can be compared.
Shivan J. Mehta, MD, MBA and David A. Asch, MD, MBA
Outcome-based payment more closely aligns payments with what patients want, which is better health rather than more health care. But these approaches remain challenging to implement.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.