I’m not sure what Mandrola is getting at regarding COI for employed physicians. I’m generally negative on the trend towards employed physicians (like the increasing majority, I am an employed physician at the moment), but I see it more as a quality of life issue for us than a quality of care issue for patients. A physician with a direct …
I’m not sure what Mandrola is getting at regarding COI for employed physicians. I’m generally negative on the trend towards employed physicians (like the increasing majority, I am an employed physician at the moment), but I see it more as a quality of life issue for us than a quality of care issue for patients. A physician with a direct financial relationship to the patient has some obvious incentives to do whatever results in more payment. If you’re salaried, the relationship between your compensation and the care you provide for the patient is actually less direct. It depends on the nature of your contract and how performance metrics may be used to affect compensation, but it doesn’t seem obvious to me that the incentives are worse for employed physicians.
Now the meta-level concern of physicians having to deal with HR and potentially losing their jobs if they aren’t acting in the company’s interest, that is a huge problem. And so maybe with the company riding the doctor hard you can get to the same COI you’d get to with fee for service medicine in the first place.
I think the loss of continuity of care that often comes with corporate medicine is also a problem, but not a COI per se.
I’m not sure what Mandrola is getting at regarding COI for employed physicians. I’m generally negative on the trend towards employed physicians (like the increasing majority, I am an employed physician at the moment), but I see it more as a quality of life issue for us than a quality of care issue for patients. A physician with a direct financial relationship to the patient has some obvious incentives to do whatever results in more payment. If you’re salaried, the relationship between your compensation and the care you provide for the patient is actually less direct. It depends on the nature of your contract and how performance metrics may be used to affect compensation, but it doesn’t seem obvious to me that the incentives are worse for employed physicians.
Now the meta-level concern of physicians having to deal with HR and potentially losing their jobs if they aren’t acting in the company’s interest, that is a huge problem. And so maybe with the company riding the doctor hard you can get to the same COI you’d get to with fee for service medicine in the first place.
I think the loss of continuity of care that often comes with corporate medicine is also a problem, but not a COI per se.