Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, April 12, 1990 TAG: 9004120799
SECTION: NATIONAL/INTERNATIONAL PAGE: A/16 EDITION: EVENING
SOURCE: Associated Press
DATELINE: BOSTON LENGTH: Short
The research supports the widely held but hard-to-document idea that doctors' own financial interests play a role in determining the kind and amount of care they give their patients.
"As in most professions, money matters," said David Hemenway, a Harvard School of Public Health economist who directed the study.
The report, in today's New England Journal of Medicine, measured what happened when a chain of walk-in clinics changed the way it paid its doctors. Instead of a flat hourly wage, doctors could earn a percentage of all the fees they generated.
With this financial incentive, they boosted the number of tests and X-rays they performed by about 20 percent.
The study was conducted in 1984 and 1985 at Boston-area offices of Health Stop, the nation's biggest chain of walk-in clinics with 80 centers in six states.
Nationwide, about 4,000 of these clinics have opened in the past decade. They specialize in quick care for routine health complaints, such as sprains and colds.
Dr. Mark Shankman, Health Stop's chief executive officer, contended that the study was too small and flawed to draw conclusions. But he agreed that financial incentives can influence the way doctors work.
Patients' needs differ, and doctors honestly disagree over how much - or how little - care is enough, especially when an extra test or two may rule out some remotely possible problem.
by CNB