Paying doctors for patients' results
- Kind
- Policy and health systems
Prompt
A health system plans to pay family doctors a bonus of up to 15% of their income based on their patients' results, such as how many patients quit smoking, keep their blood pressure under a set target and attend recommended checkups. Supporters say doctors should be paid for keeping people healthy, not for the number of visits they bill. Critics point out that a doctor whose patients are poor, work several jobs or have no stable housing will have worse results however hard she works, and that some doctors may quietly stop accepting those patients. Should doctors be paid partly according to their patients' results? Explain your reasoning.
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After you practice: what this question tests and how to approach it
What this question tests
- Critical thinking
- Health systems and advocacy
- Ethical reasoning
How to approach this question
This MMI station on health system funding tests whether you can see both sides of paying doctors for results: rewarding doctors for keeping people healthy sounds right, but patients' results also depend on poverty, work and housing that no doctor controls. Lay out the arguments on both sides, including the risk that doctors stop accepting patients whose results will look worse. Ask aloud how results could be measured fairly, whether effort could be rewarded alongside outcomes, and who pays the price if the system backfires. Take a clear position, perhaps with conditions, and explain what evidence would change it. When the station proposes a fix for fairness, consider whether it removes the unfairness to doctors without lowering what the system expects for poorer patients.
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