I was watching a youtube video speech by Obama. He said that doctors will be paid according to the quality of care not the quantity of care they give. Does he have any idea what he is talking about? Does that mean we will get paid as much or more in pathology if we spend all day looking at one cervical cone or lumpectomy rather than looking at 6 of them? Because surely that is better care.
I am being facetious because I know that quality vs quantity is just code for transferring money to primary care and rewarding primary care docs to document that they, you know, checked the sodium value if they ordered it, etc...
Pathology is already the highest quality of care and can only be reimbursed per case signed out.
I don't think he's the only one pushing "quality-based compensation." Many people feel doctors should be paid on the quality / outcome of the care they provide...though I can't foresee it translating into anything other than a govt. sponsored panel (maybe of physicians) arbitrarily determining the "value" of treating disease "X" based on avg expenses and what they think it's worth compensation-wise, which would follow that bad outcomes = physician didn't do his/her job (because patients don't have a responsibility in the patient doctor relationship, right?) = you don't get paid.
On the one hand, it's very disturbing to see fields like derm, GI, etc, rake in $$ hand over fist because of the current reimbursement strategy. And specific to pathology, you can't deny that a large number of immustains (which really add $$$$ to the bills, especially with heme) are unnecessary...but what % of them are ordered defensively to C.Y.A.?
Trying to incorporate outcome-based compensation schemes to path would be impossible. What are they going to do? Withold payment until the disease process has run it's course, for better or worse?
"Hey that lady you dx'd DCIS on 20 years ago? She actually had invasive carcinoma. You've been named in a law suit. AND, you have to repay us that $20 for signing out the case wrong."
Pathologists want to make the right diagnosis because:
1.) they want the patient to receive the appropriate care
2.) they want the normal life- and career-fulfulling gratification that's inherent to the field
3.) they don't want to get sued
Adding '
4.) your wages will be garnished if you make the wrong diagnosis' is redundant.
