Excellent points. I find it facinating how much they promote that these doctors are salaried and not paid based on percentage of charges. What most people don't understand is salaried physicians typically receive what has been dubbed "pay for performance" bonuses. They get financial bonuses for a variety of things. Some receive financial rewards for good HEDIS (Healthcare Effectiveness Data and Information Set) scores which measures the quality of the care they deliver. Unfortunately they also often receive bonuses for keeping referrals to specialists low, keeping hospital admissions at a set number, or limiting expensive lab or diagnostic tests. Having worked in health care administration most of my career and I always ask any provider I see if they have any financial incentives to limit the number of referrals to specialists or for testing? If they say yes, I ask what is the time frame of these measures? Monthly? Quarterly? and then schedule my visits accordingly. (You'd be surprised how many more lab tests are ordered or referrals to specialists made at the beginning of the measuring period vs towards the end, when the provider knows they have exceeded or are close to exceeding their expected numbers). There are pros and cons to every system used to compensate medical providers. As a patient, I simply want to understand what system my provider is under so that I can manage my care accordingly.
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