NCPA - National Center for Policy Analysis


October 25, 2006

Why do doctors so rarely talk to patients by phone or e-mail?  When use of the computer is ubiquitous among other professionals (accountants, lawyers, architects, etc.), why do so few doctors maintain their patient records that way?  Why do so many doctors prescribe medicines without knowing what they cost?  And even when they know about generic substitutes, why don't they know those costs, or where patients might shop for drugs to get the lowest price?

My recent article, published online by Health Affairs, explains all these problems are a direct result of the way doctors are paid. 

Doctors are not paid to talk to you on the phone or by email. Blue Cross doesn't pay for consultations that aren't face-to-face, in the doctor's office. Neither does Medicare, nor do most employers.

Lawyers are paid by the hour; but doctors get paid by the task.  There are many things doctors could do to improve quality and enhance patient satisfaction, not to mention control overall costs, but these things are not done because doctors get no compensation for doing them.

The bottom line is if we want more patient-pleasing, higher-quality medicine, we have to change the way we pay doctors.


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