For the past few decades this country has kicked around an idea that some believe might spur a cheaper, better quality healthcare system – the idea that American doctors should be given “report cards” and “grades” which, in theory, would provide accurate public notice of the doctor’s competence. These grades would be based on things like individual surgeon mortality rates, and other outcomes, as well as whether physicians followed strict pay-for-performance government policies. Such report cards have been mandated since the implementation of the Affordable Care Act, and, unfortunately, they have been unable to achieve the intended results. The continuation of this grading system is a terrible idea.
One common use for the “doctor report card” has to do with surgeon care and performance. Surgeons will be given a competence grade based solely on mortality rates so the public can “wisely” determine who they would like to operate on them. While this may seem logical on the surface, such grades have caused more problems for doctors and the general public than were probably intended.
Surgeons, knowing they are being graded, are ceasing to operate on anyone who is considered “high risk.” A high risk patient is someone who is deemed more likely to die on the operating table. While high risk patients are in need of operations more than others, they are being turned away. Surgeons are refusing to operate on anyone who could potentially raise their mortality rates, and thus lower their professional grade, which they need to keep at a competitive level or else they risk losing their jobs. At this point, according to Sandeep Jauhar, a cardiologist writing for The New York Times, doctors won’t even take the time to meet with patients to assess their condition if they are considered “high risk.” They now base their decisions on patient files only because “the state agencies monitoring surgical outcomes…penalize…for a bad result.” I can’t speak for everyone, but it seems to me that we should encourage our doctors to make informed and thorough decisions at their own discretion concerning what is best for those they treat and operate on.
Thanks to Obamacare, pay-for-performance is now underway. Such a policy was mandated because there has apparently been concern that doctors have been calling for more tests to be taken than are necessary in order to increase their personal incomes, making healthcare overall too expensive. Government officials developed a strict set of “standards” and “directions” for physicians to follow in order to save money and even generate “better care.” While I’m sure there are some doctors out there who may over-treat, it bothers me that government officials think they could possibly know what is best when it comes to medical care in this country. It’s insulting, really, to doctors who have spent seven to twelve years practically as slaves to the medical industry and our society in order to become qualified to practice medicine. This “government knows best” attitude, and the regulations they have imposed, is nothing but insulting to arguably our most respected profession.
As Roger Stark wrote for The Washington Policy Center, “Medicine is as much an art as a science.” No medical case is exactly the same as another, it is impossible to successfully treat patients if our doctors are acting out of a government-regulated “cookbook.” My mom, an M.D. herself, agrees. Sometimes what works for most people doesn’t work for others, and the government has absolutely no way of knowing that. Threatening doctors to act as the government sees fit is disrespectful, ignorant and, most importantly, coming at the cost of what is considered the best medical care in the world.
@TheChrony