I’ve seen a lot of comments on the web about doctors getting free lunches from pharmaceutical companies as an explanation for why we hand out so many prescriptions. I don’t actually know anyone in my group of 30 or so doctors who sees drug reps anymore. The programming by we are influenced these days is much harder for our patients to see—even reporters seem not to know to write about it. It’s called “Pay for Performance,” or P4P.
P4P is exactly what it sounds like it is: Insurance companies pay us more if we write more prescriptions and order more tests. They hold back a percentage of our payment until the end of the year, and then measure how well we’ve “performed.” If we played by their rules, we can get the rest of the payment. If we haven’t, the insurance company wins the right to keep that money.
The medications and interventions most often measured in “quality” programs are cholesterol, blood pressure, and diabetes pills, vaccinations, and mammograms.
What do you think about this practice?
Do you think it’s a good idea for your doctor’s pay to be tied to the number of prescriptions you buy?
Do you think your doctor may have been influenced this way to put you on a medication or order a test?