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10/04/2011

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Beth Haynes, MD

Where does patient choice come into this? What if the patient does not want the screening? Does the doctor get penalized for this? Is this a practice standard you are setting? In other words, who is doing the evaluating and what are the consequences of not meeting the standard?
Thanks.

Bill Gardner

Great question. The patient has the same rights to refuse treatment that he or she ever did. And if you happen to have a panel of patients who refuse good care, despite your best efforts to persuade them, you would be penalized in a pay-for-performance situation. This gives you an incentive to build trust and educate your patients, which of course was already an incentive for you. This is one of the reasons why quality measures tend to focus on practices that benefit the patient right in front of you, as opposed to practices that have general public health benefit (vaccines of course have both).

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