Sunday, July 20, 2008

UK Surgeons to have pay based on how patients do after surgery

Paying surgeons based upon how good of a job they do seems to have generated all sorts of concerns in the UK. The most bizarre response though is this:

Patients' groups said those facing surgery would be "horrified" by the proposals and questioned why doctors should be paid a premium for fulfilling their basic duty. . . .


Why should patients mind this? After all, they don't have to pay directly for the service and if it generated higher quality care, they are better off. Of more concern is this:

Leading surgeons said that this could deter doctors from taking on higher-risk patients, such as the frail and elderly, and from carrying out complex operations. . . .


But the simple way to deal with this is to figure out what the right yardstick is to measure the job that the surgeons are doing. If they save a high risk life, they could get paid more. Indeed, if the pay was enough, you would have the opposite of what the surgeons here fear -- everyone would want to do the high risk patients. Yet, it sounds from the discussion that the payment schemes are not going to differentiate the risks involved.

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