Are there fewer surgeries when doctors are paid a salary. Check out this new study discussed in the NY Times.

Are there fewer surgeries when doctors are paid a salary.  Check out this new study discussed in the NY Times.

Have you ever wondered if your doctors recommendation for surgery was for your benefit for theirs?   There are many people who had C-sections wondering if it was really necessary.   Millions have had appendectomies while in Europe, antibiotics for years have cured the infection.

Was your doctor influenced by how they are reimbursed?   This was suggested in a new study discussed in the NY Times regarding doctors who are reimbursed fee for service for a procedure vs. managing a problem more conservatively.

It is true that many of the incentives in our healthcare system at the hands of our insurance companies are perverse.   If you pay more for tests, or more for facility fees, doctors will buy the facilities and do what they get paid for, but not always.  If you pay per service for a surgery, vs. more conservative methods,  doctors will modify their practices to meet their financial goals.

While it is true that many surgical procedures can be quite helpful, and some can save lives, it is also true that some doctors reportedly have done surgeries instead of treating medicinally which would have been more cost effective because they are incentivized to do so.

Fee for service is not a bad thing, but it has been demonized by both insurers and CMS as a cost driver.   We are not widgets, and sometimes, care requires more time, more instruction and it is appropriate to pay for this increased level of service.   It is not appropriate to do surgery because it pays better than conservative or medicinal care that may offer the same or better outcomes.

Check out this interesting but disturbing information recently discussed in the NY Times here

Surgery or Drugs? Doctors’ Pay May Influence Choice


Sometimes doctors choose to do surgery not because it is absolutely preferable to other treatments but because they get reimbursed for it, a new study suggests.

Researchers looked at patients with a narrowed artery in the neck, a condition called carotid artery stenosis that can be treated with surgery or managed with medicine and lifestyle changes. The choice is often a judgment call.

Some were treated in a fee-for-service system, which pays doctors for every procedure they do
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