One more response to your comment, Ivan. According to an article on Science Daily “Several health systems well-known for high-quality of care, such as the Mayo Clinic, the Cleveland Clinic, and the Kaiser group in California, pay physicians salaries without incentive for volume of services performed.”

The same article discusses research done by Carnegie Mellon University that associated the fee-for-service system to create incentives for doctors to order more, and different services than are best for patients. It was posted in the Journal of American Medical Association (and is behind a paywall).

I’ve learned that all hospitals are now required to post a patient price list. But, some try to make it hard for patients to find those lists. And, that doesn’t mean the hospitals have switched to paying physician a salary.

From what I’ve read today, I conclude that one reason more hospitals haven’t switched from fee-for-service to paying physicians a salary is because change is hard. A Forbes article notes that the majority of healthcare providers are still paid fee-for-service. From the article:

“When doctors work in a system where they are based on volume, they see doing more as better — even when the scientific literature contradicts that perception. It’s not that providers don’t understand the benefits of getting paid for the value of their care. Rather, the rewards of their habit and the pain of quitting it within the context of American healthcare are simply too great. That’s why only 7% of practicing physicians express enthusiasm for “eliminating fee-for-service payments.”

I hope this answers your questions! :)

Freelance writer with invisible illnesses and chronic pain. Poet, podcaster, video game player, creator of strange artwork, they/them

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