Following my most recent post about the P4P system, there was a rather interesting comment left by a "Dr. Caligari:"
hmmmm . . . . so you docs are all upset that medicare is going to use a payment system that has yet to be tested in rigorous studies. And, how may of the things that YOU do on your patients, have, in fact, been tested in nice, randomized double blind studies? Not that much, I suspect . . . (the percentages I hear are between 15-35%). Oh, but that doesn't stop you irresponsible quacks from doing episiotomies (do you enjoy slicing women from the vagina to the anus?), removing tonsils, even doing physicals--none of which have strong evidence based support.
AHH--but when it comes to something that cuts into your INCOME--and may prevent you from getting that third Lexus--why we're all evidence-based now!
Observe when confronted with their own logical inconsistencies, doctors just get nasty and personal. And so lacking in senses of humor--apparently the Lexus remark was too close for comfort . . . .If Dr. Caligari really believes that physicians in the US are dead set against improvement in patient care, preferring to practice only by the light provided by anecdotal evidence and the occasional "experimentation" on patients, he may need a short stay in the lunatic asylum so aptly displayed in the movie he takes his name from. And as for the "humor" remark, I kind of think that the epithet "vile hypocrites" displays a certain lack of wittiness that even a third grader might hope to achieve with a "knock-knock" joke. I suspect that many would charitably describe the phrase "irresponsible quacks" as a "nasty and personal" remark as well (and not so charitably as something else altogether).
As I said, its hypocritical to demand evidence based payment system, but not practice evidence based medicine. If anything, I would think you should have lower standard (i.e., more open to experimenting) on payment systems than human beings.
I did get a good laugh out of all of this, however. SWIMBO occasionally reads my blog, and paged me earlier today to demand not her third, but just ONE Lexus!! Dammit, Dr. Caligari, now you've blown my cover! I'm just a rich as sin surgeon, generating tons of cash from experimenting on patients, but I have tried to hide it all from SWIMBO so I can retire at 45 and enjoy drinks with parasols in them on the beach every day! But noooooo, now I need to go buy a few Lexuses just to make the little woman feel like she's keeping up with all of the other fabulously wealthy doctors' wives --- or is it "Lexi?" I'll have to call my old Latin teacher, Fr. Bayhi, to find out.