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Building physician consensus

. 4 Comment(s)

In this New England Journal of Medicine perspective, Meredith B. Rosenthal writes about the prospect of achieving compromise in payment reform:

Which recipe will yield the best balance of meaningful incentives for cost control and quality improvement, risk protection for providers, and selection incentives remains to be seen. The prospects for payment reform, however, hinge more on politics than on economics. Given that the two major goals of reform are to constrain spending growth and to move money from more intensive to less intensive settings — from doctors who carry endoscopes and scalpels to primary care physicians, for example — there will be substantial resistance to even the best-designed plans.

How should Congress address issues of competing interests in payment reform?  Could doctors come to an agreement or a compromise with our own community?  What would help facilitate that?

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  1. anjali


    I am a family physician and my husband is a neurosurgeon and we debate this issue frequently. I find that I face insurance companies that do not provide fair reimbursement that is at least equal to that which Medicare pays. My husband states his specialty's malpractice insurance is so high due to the national level of frivolous suits, that high risk specialties need higher reimbursement. It is definitely a complicated path, but targeting insurance company policies and malpractice reform may be a start.

  2. Kelly Brown


    Hi, very nice post. I have been wonder'n bout this issue,so thanks for posting

  3. JaneRadriges


    Hi, gr8 post thanks for posting. Information is useful!

  4. Jean Antonucci Md


    I am a rural family practice doc. The head of the Maine Medical Association tells me that specialist malpractice costs do not explain their salaries. Orthopedic surgeons make 5 times what I do partly becasue I make so little. Maine is 42% public funding, and in my location 33% is Medicaid. Orthopedic docs' malpractice is about twice mine

    Now, see patients at by an othropod and see While malpractice must be taken into account two other things must occur - we must STOP the toxic burden of administrative costs killing primary care, and we must indeed have specialists who are willing to relook at their salaries and their use of procedures. Neurosurgeons are not folks I think of as abusing procedures, but everyone of us has some hard work ahead, and frankly primary care DOES need to be compensated fairly. I sat next to specialists in med school. They are not 5 times smarter 5 x harder working than me, malpractice, length of traingin or not. The disparity is inappropriate.

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