DocShive's Musings
DocShive's Musings

When the Only Thing Compensated is Time

I appreciate that healthcare, as a profession, is in the painful birthing stages of the change in the way healthcare providers are reimbursed.  The proposed method of decreasing provider documentation requirements and billing just on the time spent has predictable adverse consequences.
If you and I are stockbrokers, we have no limit on our potential income.  Deciding that our clients should buy or sell a stock generates commissions on many, many clients, perhaps several times hourly.  As professionals, all providers have to "sell", is our individual time spent currently in front of patients. A wise mentor told me long ago that I would never be satisfied in a job that reimbursed solely on an hourly wage; that I needed to be paid on a commission structure based on the quality of the work performed. 
There is no mechanism in place to compensate providers for the time spent on non-face-to-face essential tasks: reporting results, prior authorizations, medication refills, etc.
So providers may all become like lawyers and bill for every second of what they do, find ways to "extend" ourselves by working with advanced practice professionals, use telemedicine,  or   --  more likely --  dramatically slow down their availability and extend the time spent with each patient, knowing that  8 hours of time will be reimbursed the same whether one patient is seen that day or 25.
What that would do to patient access is a predictable debacle.
And once the insurers establish that fees can get paid for interacting with patients that are not in front of a provider, how long will it take for that care to be "outsourced" to a cheaper provider?  I used to think doctors and barbers were the only professions immune to outsourcing.
Now I'm down to hairdressers. 



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