New compensation structures start with the best of intentions: keep costs down and patients healthy. But healthcare providers can become a casualty on the road to lower costs.
So, is your pay system causing provider burnout? The short answer is: probably.
Exhibit 1: Pay for volume.
Volume-related incentives were the compensation fad of the last decade. However, since provider burnout is exacerbated by feeling disconnected to patients and not having enough time to spend with them, this short-sighted policy contributes to many frustrated providers. As Dr. Robert Centor said at the Medscape Roundtable, "Too often the current finances of medicine force physicians to spend inadequate time with patients… I would argue that our payment system, especially for outpatient internists and family physicians, is a leading cause of burnout."
Exhibit 2: Pay for performance.
A recent New York Times article shows how the Affordable Care Act is prompting hospitals to link provider pay with performance (measured by patient outcomes, cost containment, and patient satisfaction.) It sounds like a plan that makes sense, but physicians tend to resent this time of micro-level intervention in how they care for patients. And some point out that they're held responsible for things they can't influence (like whether a hospital floor is clean.) In fact, experts say that this plan of "carrots for doctors" is unlikely to work, even outside of physician considerations.
There is no doubt that healthcare has to be more accountable and costs need to come down. But when it comes to designing a compensation plan that works, healthcare provider needs have to be front and center. The big problem with igorning provider needs and stressing them out? Well, it doesn't work. Patient satisfaction starts with happy healthcare providers. And research shows that doctors with lower incomes, more debt, and less savings tend to be more burned out than their peers. So if your compensation structure is burning out your providers, it's very possible that you're gouging patient outcomes and even elevating costs at the same time.
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