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Noveed Hussain

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Why not pay doctors after getting rid of disease...?

I was just that we should pay the fees of doctors after getting rid of disease or feeling better than before it will reduce the wrong diagnoses and doctors will pay more attention.

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    Sep 26 2012: Outcome-based payment is very tempting, but it seems impractical to me. Here are a few thoughts:

    - What about doctors treating injuries? Not all injuries can be totally healed.
    - What about incurable diseases?
    - What would motivate a doctor to take on difficult cases, if s/he was only being paid when someone felt better or was cured. Doctors would only be motivated to take on easy-to-solve cases.
    - Since many people in the U.S. are not the direct customer of their physicians (insurance companies are), how much sense does it make to give insurance companies even more control over the decisions made by a physician?

    Great question!
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      Sep 26 2012: Well, I really like the term outcomes based. Because if the outcome were identified in each of your thoughts and correctly measured.

      So lets take a physician treating heart disease. They would get a higher reimbursement if hospital visits were less than twice a year or something like that. Even if the patient was terminal, perhaps six visits per year.

      Or someone with a knee replacement, they would get higher reimbursement if the patient was free from infection and had a 120% increase in joint function as based on range of motion measures.

      It might actually work...
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        Sep 26 2012: Interesting point, Linda. This approach would certainly require a great deal of extra thinking about what metrics would be used to judge outcomes. Of course insurance companies would likely be the drivers of those metrics in the U.S., so I'm not sure how that would turn out.

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