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Why Docs are 'Constantly Encouraged to Do Bad'

Joe Cantlupe, for HealthLeaders Media, August 22, 2013

While Accountable Care Organizations and bundled payments and other fiscal models offer some hope for change, too often healthcare moves glacially, and can't deal quickly enough with problems, de Brantes told me.

When a healthcare academic paper is written, for instance, by the time the major focus prompts debate and change, it is often too late, de Brantes says. "We need to encourage rapid-cycle implementation where folks learn, and figure out what is appropriate," de Brantes says.

Current financial incentives to physicians "negatively affect the professional's motivation by influencing provider treatment choices and potentially harming patients who lack of easily accessible information on the value of treatments," de Brantes writes.

Among the immediate obstacles to true reform that undermines physician "motivation," de Brantes says:

Variability of Care
Health systems need to continually restructure payment models for various disease conditions and overcome variability of its funding for care, from disease to disease, specialty to specialty, subspecialty to subspecialty and region to region. As for many proposed payment models that now exist, certain modes of care, variations in oncology or cardiology, for instance, are not properly defined for proper physician payment, he says.

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2 comments on "Why Docs are 'Constantly Encouraged to Do Bad'"


John Jaffe MD (8/23/2013 at 12:46 AM)
Please show me the evidence that physicians working under fee for service arrangments "order too many tests" (which usually they don't profit from), "do too many procedures", etc. It's possible that physicians working under capitation arrangements do too few! Thank you.

Jeff Angel (8/22/2013 at 2:39 PM)
Article is full of generalized, over-used debate points with no real ideas on how to improve medicine or no validity to the fact that even if waste is cut to zero, which technically cannot happen in a multi-variable system, there are not enough resources for the amount of pathology going forward. Blaming doctors is a good sound byte, but if docs worked for minimum wage there still is a deficit. To make like you are solving " medicine" with getting rid of bad behavior/bad docs is intellectually naive or dishonest. Demographics will require rationing....so call it out...we need to ration, and quit bashing docs New article in JBJS.....Total knee replacements save society 12billion dollars a year....MPHs and brainwashed media and politicians will reject that study, because of bias...please become scientific in your reporting to help us all.