Our readers speak out.
Despite the fact that there is little or no evidence showing cost savings or improved patient outcomes with various value based quality programs and pay-for-performance schemes, CMS and many insurers seem dedicated to expanding these programs and the endless number of acronyms used to describe them.
Many primary care physicians cite such programs and the administrative burden that they impose as a leading cause of burnout and job dissatisfaction. The specifics behind this include tedious data entry, unfair, unrealistic or uncertain performance measures.
Even though it seems obvious that holding someone responsible for things over which they have no control is wrong, these programs are almost entirely predicated on just that. And even though it seems clear that requiring physicians to spend a large percentage of their time doing tedious data entry is counterproductive, wastes patient care time, diminishes access to care and leads to burnout, that is yet another hallmark of such programs.
As such programs become increasingly ungainly and transition from pay-for performance to punishment-for-compliance-failure it seems the time is right for a primary care bill of rights. I think it should look something like this:
Physicians must embrace these simple, common sense concepts and use them to inform employers, patients,payers and the government how cumbersome, unfair and ineffective such programs have become.
George T. Barron, MD
Rock Hill, S.C.