Thanks for your article about pay-for-performance. I do appreciate that you gave consideration to the "other side" of the frenzy about pay-for-performance.
As a physician, it is my duty to consider each patient as an individual. I agree that practice standards are important, but every patient is different, and I give serious consideration to the specific needs of each person when I order tests, medications or make any recommendation. Population-based healthcare is not only dangerous, but frankly is an expensive means of trying to make all patients look alike. I am a professional, quadruple-boarded, and my patients pay me for my expertise. They have insurance as a means of paying for the catastrophe that they hope never happens. The thought that the government, an employer or an insurer can create the standards of care and force physicians into a fiduciary abyss where many have to accept pay-for-performance in order to stay in business makes me shudder, however increasingly real it has become.
Marcy Zwelling, M.D.Private medical servicesChoice CareLos Alamitos, Calif. To submit a letter to YOUR VIEWS, click here. Please include your name, title and hometown.