The author brings about many valid arguments when addressing the issue of the RUC and it may be one of the reasons why there is such a low supply of primary care physicians in this country.
As an advisory committee on the fee schedule, RUC should be expanded to not primarily consist of specialists, but primary care physicians, insurers and patient advocates, to eliminate any biases when developing the fee schedule and determining how much providers will be compensated. Votes should be transparent and accountable so that citizens are aware of the decisions being made about how much they will be paying for services.
The fee schedule itself should be revamped since it was created in the 1980’s and it may be beneficial to also include some incentives for primary care physicians, possibly for those practicing preventive medicine (similar to the UK). This may help to increase the supply of primary care physicians and quality of care (if you pay someone more you will most likely get a better quality service and having more primary care physicians equals more access to preventative medicine).
Incentives rarely lead to better care. Yes, you will get more of the behavior you are looking for, but only in the same way someone follows a recipe. In psychological studies done here at the University of Rochester, Ed Deci and Richard Ryan have shown over and over that extrinsic rewards and punishments lead to worse performance on tasks that require problem solving.
A better approach in my humble opinion is to make medical school free. That removes money out of the picture (mostly). I bet you would find that more people go into primary care for intrinsic reasons instead of moving into specialties because of the fear of overwhelming debt. I believe that one change would lead to a paradigm shift in the medical community.
The author brings about many valid arguments when addressing the issue of the RUC and it may be one of the reasons why there is such a low supply of primary care physicians in this country.
ReplyDeleteAs an advisory committee on the fee schedule, RUC should be expanded to not primarily consist of specialists, but primary care physicians, insurers and patient advocates, to eliminate any biases when developing the fee schedule and determining how much providers will be compensated. Votes should be transparent and accountable so that citizens are aware of the decisions being made about how much they will be paying for services.
The fee schedule itself should be revamped since it was created in the 1980’s and it may be beneficial to also include some incentives for primary care physicians, possibly for those practicing preventive medicine (similar to the UK). This may help to increase the supply of primary care physicians and quality of care (if you pay someone more you will most likely get a better quality service and having more primary care physicians equals more access to preventative medicine).
Incentives rarely lead to better care. Yes, you will get more of the behavior you are looking for, but only in the same way someone follows a recipe. In psychological studies done here at the University of Rochester, Ed Deci and Richard Ryan have shown over and over that extrinsic rewards and punishments lead to worse performance on tasks that require problem solving.
ReplyDeleteA better approach in my humble opinion is to make medical school free. That removes money out of the picture (mostly). I bet you would find that more people go into primary care for intrinsic reasons instead of moving into specialties because of the fear of overwhelming debt. I believe that one change would lead to a paradigm shift in the medical community.