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Consequences of Doctor's Pay for Performance

Pay for Performance, P4P, is an initiative started by employers, insurance companies and supported by Medicare to reward doctors and hospitals for quality with extra bonuses for better care. However when does better care become a risk and cause more harm than good for the patient.

According to the Centers for Medicare & Medicaid Services, "the foundation of effective pay-for-performance initiatives is collaboration with providers and other stakeholders, to ensure that valid quality measures are used, that providers aren’t being pulled in conflicting directions, and that providers have support for achieving actual improvement".

So I understand they are trying to improve our healthcare system but is using monetary rewards the best course of action? Doesn't this add more pressure to doctors who already have so much to worry about? Can't more tests and antibiotics prescribed as preventative measures have detrimental effects on the patient- not only on their health but their wallet?

The New York Times article "The Pitfalls of Linking Doctors’ Pay to Performance" out early in September commented on one of these cases- an older male patient was receiving an intravenous antibiotic every day for the pneumonia he never had, which caused and infection and a 2 week hospital stay. Doctors want us to think that they were being cautious by diagnosing the pneumonia early on, but with P4P the hospital actually received a bonus for administering "antibiotics to pneumonia patients in a timely manner".

I am not saying that all doctors are selfish, greedy and want more money, but isn't all this over treatment another costly aspect of our already $2.1 trillion healthcare industry?