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COPYRIGHT 2006 International Medical News Group
It was with dismay and astonishment that I read Dr. Faith Fitzgerald's guest editorial, which can only be described as a rant ("The Perils of Pay for Performance," April 15, 2006, p. 14).
Clearly, with regard to screening and follow-up, preventive medicine routinely falls short of the goals of well-established guidelines for procedures such as mammograms, Pap smears, glycohemoglobin measurement, etc. What is the main barrier? Patient resistance. Getting patients to follow advice requires a great deal of effort to implement a system of chart review, patient contact, and re-review. It is appropriate to reward physicians who go the extra mile to ensure patient compliance, particularly since none of this time-consuming effort is currently reimbursed.
In contrast, there is the news about the perils...
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