Are doctors payment incentives ruining health care? Check out this NY Times article.

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doctor dollar Are doctors payment incentives ruining health care? Check out this NY Times article. Doctors are faced with numerous forces that are coercing them into certain behaviors that may not necessarily be good for your health. Some doctors are recommending drugs based on your insurers wants, rather than your needs. Others, if they fail to follow a care path to help an insurer meet certain targets that may be detrimental to your health, rather than be helpful to it are penalizing them financially. In other cases, certain hospital systems have production targets. Basically, healthcare is being commoditized, using a one size fits all model that does not fit all. Some of us have certain problems due to genetics, and just body chemistry. Cholesterol medication is pushed on the public but it has horrible side effects for many people, and its overall work has never been proven. Doctors are increasingly more frustrated with having to do things that they may not agree with and the personal touch of healthcare is being consumed by corporate interests that are not lowering the cost of care, but coercing doctors to behave in a way that they may not be comfortable with. Some have opted to go cash and drop all or most insurers, however, the insurance industry is now making that approach more challenging as the new Obamacare plans are mostly EPO, with no out of network option, which is likely intended to try to force doctors back into their networks. Others have joined hospitals that purchased their practices because they believe it is better for both them and their patients. Check out this article from the NY Times here

WHEN we are patients, we want our doctors to make recommendations that are in our best interests as individuals. As physicians, we strive to do the same for our patients.

But financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients. Insurers, hospital networks and regulatory groups have put in place both rewards and punishments that can powerfully influence your doctor's decisions.

Contracts for medical care that incorporate "pay for performance" direct physicians to meet strict metrics for testing and treatment. These metrics are population-based and generic, and do not take into account the individual characteristics and preferences of the patient or differing expert opinions on optimal practice.

For example, doctors are rewarded for keeping their patients' cholesterol and blood pressure below certain target levels. For some patients, this is good medicine, but for others the benefits may not outweigh the risks. Treatment with drugs such as statins can cause significant side effects, including muscle pain and increased risk of diabetes. Blood-pressure therapy to meet an imposed target may lead to increased falls and fractures in older patients.

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