We assume that physicians are focused on quality of care. No doubt, the medical profession, traditionally, has been at the forefront as patient advocates and promoting advances in quality of care. We also know, however, that despite best intentions and best efforts, using empirical hard data, we know that the quality of care provided in segments of our healthcare system is far from ideal.
Much of this has to do not with a lack of good intentions but a lack ofinformation and coordination. Every healthcare reform discussion and initiative is focused on better coordination and the expected higher quality that will result.
We’ve been talking for years about modifying the reimbursement methodology to promote this type of coordination and to reward facilities and providers for making it happen (An example – Center for Medicare Services Value Based Purchasing Program). A recent study by Merritt Hawkins, one the largest physician recruiting firms, indicates that when it comes to physicians, we aren’t there yet. From the Wall Street Journal Health Blog:
The company’s annual report on recruiting incentives finds that 74% of the jobs they recruited for in the year ending March 31 featured a performance bonus. Of those that offered such a bonus, in 90% of the cases it was linked to “fee-for-service style volume.”
Meantime, fewer than 7% of the jobs offering bonuses rewarded physicians for meeting quality or cost goals. “Volume/production remains the standard,” the report says, despite the fact that “health reform encourages the use [of] quality or cost-based compensation metrics.”
As the trend continues toward increasing employment of physicians by hospitals, we need to do more than just pay lip service to the idea that we want a medical staff that is focused on improving key quality metrics and the patient experience.
First, change the recruiting and hiring process to emphasize these priorities and only select physicians who have a proven track record and an ability to collaborate on quality and patient satisfaction initiatives. Second – We believe that younger physicians, particularly, will be more receptive to financial rewards tied less to volume and more to quality and patient satisfaction. It’s time to shift our focus a bit from just adding talent, to adding the right talent and rewarding them for the right behaviors.