Specialist Doctors Head for Exit as U.S. Shifts Payments

[Shikima]

http://finance.yahoo.com/news/specialist-doctors-head-exit-u-050100415.html

Being that I'm in PP and I've hear bits and pieces of this happening..... it appears this could be a new reality.
Does anyone have more detailed information on this and could extrapolate how this would effect those who see Medicare?

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[heyjack70]

but what will happen to psychiatrists???

 

[milesed]

No one in my area is leaving. Yet.

 

[Shikima]

I'm super concerned in migrating from a fee-for-service model to an outcome based model.

I could see the slippery slope in this developing where we'll have to show that we have a % of no-shows and will be docked pay if it's above a certain percentage like at the VA.

 

[wolfvgang22]

Fee for service already kind of sucks in it's current form. It remains to be seen if an outcome based model will be worse or not. The concern that outcome measurement is much more fraught with subjectivity than fee-for-service, at least that's my problem with it. It all depends on the "outcome" desired, and how they measure that:

Patient satisfaction? Thanks Press Ganey, lets just give everybody benzos! That's what some providers do already.
Number of suicides/attempts?
Number of hospitalizations? (In my clinic, it's usually the same handful of chronically ill patients.)
Percentage of population on more than two psychotropic medications (polypharmacy)?
BMI?
BDI-II score?​

 

[Baller MD]

Fee for service already kind of sucks in it's current form. It remains to be seen if an outcome based model will be worse or not. The concern that outcome measurement is much more fraught with subjectivity than fee-for-service, at least that's my problem with it. It all depends on the "outcome" desired, and how they measure that:

Patient satisfaction? Thanks Press Ganey, lets just give everybody benzos! That's what some providers do already.
Number of suicides/attempts?
Number of hospitalizations? (In my clinic, it's usually the same handful of chronically ill patients.)
Percentage of population on more than two psychotropic medications (polypharmacy)?
BMI?
BDI-II score?​

I agree with this. A satisfaction model developed by anyone who isn't a physician is a recipe for disaster. Even ones developed by physicians should be heavily scrutinized.

 

[Shikima]

IMO no satisfaction model needs to be developed in a heavily involved and subjective field such as this (Medicine). It is impossible to please 100%, 100% of the time.