Talking about money: how primary care physicians respond to a patient's question about financial incentives.
Patients sometimes express concern about the influence of "perverse" financial incentives on their care. We recruited a convenience sample of 101 primary care physicians and obtained information on their compensation. Then we audiotaped them as they role-played a response to a videotaped mock patient who asked them how they were paid and how their method of compensation affected clinical decisions. Overall, 36% of the physicians did not give enough information in their role-play response to allow an independent determination of how they were paid. Adopting a broad spectrum of attitudes and approaches, nearly every physician avoided discussing the role of incentives and stressed instead that he or she could be trusted under any circumstance.
Pearson
Steven D
SD
Center for Ethics in Managed Care, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass., USA. steven_pearson@hphc.org
Hyams
Tracey
T
D000328:Adult; D000739:Anecdotes as Topic; D001291:Attitude of Health Personnel; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010816:Physician Incentive Plans / Q000191:economics*; D010819:Physician's Role; D010817:Physician-Patient Relations; D010820:Physicians / Q000191:economics* / Q000523:psychology; D011320:Primary Health Care / Q000191:economics* / Q000592:standards; D011787:Quality of Health Care; D012052:Reimbursement, Incentive; D011795:Surveys and Questionnaires; D014481:United States