Docs support incentives; balk at reporting

A survey shows U.S. physicians support pay for performance plans, but oppose public reporting of assessments for fear of harming some patients.

Although three of four primary care physicians told the University of Chicago survey they support using financial rewards as an incentive for better medical care, most oppose public reporting of such quality assessments at the individual or group level.

Study author Dr. Lawrence Casalino said physicians surveyed had two chief concerns: less than one-third believed current quality measures were up to the task and only slightly more than one-third believed the government would try to make such measures accurate.

The physicians also worried such plans might cause doctors to shun sick, poor or non-compliant patients and to neglect unmeasured, but equally important, areas of quality.

"I have 10-15 patients whom I would have to fire," penned one respondent. "The poor, unmotivated, obese, and non-compliant would all have to find new physicians."

The researchers sent questionnaires to 1,168 randomly selected general internists; 48 percent completed the seven-page questionnaire.

The survey appears in the March/April issue of the journal Health Affairs.

Copyright 2007 by United Press International