2024-07-27 16:30:00
Each person and each pathology must be treated individually since some patients need tests, others only a consultation, and there are those who require prolonged observation for hours or even days. Furthermore, the severity of each episode must be considered.
However, what hospitals do take into account is the time it takes for people arriving with a health problem to register, go through triage, and be seen for the first time by the physician.
The patient’s objective is for a doctor to see them as soon as possible, and for this reason, the management of health centers has sought various ways to motivate professionals to see a greater number of patients during their shifts.
One of these ways is to add an incentive per patient seen to the monthly payroll they receive regularly. This way, the more patients seen, the more money the doctor receives.
Mario Miranda, an Emergency doctor at the QuirónSalud Madrid Hospital, explained to Redacción Médica the economic incentives they receive at the mentioned health center with the goal of reducing wait times and seeing a larger number of patients during their shifts.
The incentives that doctors receive in Emergency Services
The physician mentioned that they receive one euro for each patient seen, and that amount multiplies, at the end of the month, according to the NPS scale, which reflects the evaluations made by patients in response to a survey they are sent via email days after visiting the hospital.
“Our incentives are 1 euro for each patient seen and that multiplies, according to the NPS scale, by one, two, three, or four at the end of the month,” Miranda explained.
Therefore, to that fixed part of one euro per patient, the scores each doctor receives for the treatment given to the patient must be added. These evaluations range from 0 to 10.
In this regard, the Emergency doctor emphasized that incentives “are necessary for doctors to be a bit more motivated. That helps.”
For her part, Elena Fernández, an Emergency doctor at the HM Rivas University Hospital, shared that “it has been observed that incentives are one of the factors that help reduce waiting times in Emergency services, but they are a double-edged sword and need to be carefully structured by determining different items for which they will be awarded.”
“One of the aspects that should be assessed is, of course, the time of patients seen, which allows for reducing wait times, as all team members will want to assess more patients. However, this is where special care must be taken. In Emergencies, patients with more trivial pathologies and those with more complex cases attend. Those who come for simpler cases are evaluated and treated more quickly. If a physician only sees this type of patient, they will see more people than another physician who attends to more complex pathologies,” Fernández added.
The HM Hospitales physician pointed out that “this is why incentives should not only focus on the number of patients seen, but also consider the quality of reports, the type of patients seen, the number of complementary tests requested, for example.”
Economic incentives in other hospitals
Miranda, who has worked in other centers, noted that this is not the first time he has encountered these incentives, mentioning the Hospital de Torrejón as an example.
“When I was at the Hospital de Torrejón, there were indeed incentives. A small amount was charged per patient seen, and then payment was made according to the severity of the patient. It varied depending on whether they were triaged in green (mild), yellow (moderate), or orange (severe),” he explained.
On the other hand, the Emergency physician has proposed new ways to incentivize physicians. “Everything comes down to making it a bit more attractive, and one good option could be, besides incentives, to increase the base salary of doctors because there is a shortage of professionals in emergencies, and unless it becomes more appealing, it will be difficult to attract people to work.”
Fernández indicated that “in none of the centers I have been in did incentives exist,” but added that in the centers she is aware of that are including are “financial bonuses per patient seen.”
“Incentives are necessary for doctors to be a bit more motivated” |
Do economic incentives in Emergency Services foster competitiveness?
Finally, Miranda pointed out that incentives lead doctors to see more patients and that Emergency services maintain low wait times, but he mentioned that, in some cases, it can create a sense of ‘competition’ that is not always comfortable among colleagues.
“There’s a mix. With incentives, you are pushed to be more involved and see more patients. It is true that in certain places, if one person hogs a lot, then colleagues might feel a little bad, but I would say that it promotes that Emergency Services perform better and that wait times do not increase,” he stated regarding this.
For Fernández, the ‘extras’ for each patient seen can indeed foster a competitive environment, but she added that the role of the Emergency coordinator is key to preventing that from happening.
“The existence of incentives will generally create a competitive atmosphere within the team, but I believe the role of the service coordinator is fundamental in this regard, and if they are not only based on wait times, but also, as I said earlier, assess other aspects of quality care, it can generate healthy competition where the main beneficiary is the patient,” she commented.
Although it may contain statements, data, or notes from institutions or health professionals, the information contained in Redacción Médica is edited and prepared by journalists. We recommend that any health-related questions be consulted with a healthcare professional.
The Future of Urgent Care: Incentives and Efficiency
As hospitals continue to grapple with increasing patient volumes and the necessity for timely care, innovative strategies to enhance efficiency in emergency departments are emerging. One significant trend is the introduction of financial incentives for medical professionals aimed at reducing wait times and improving patient throughput.
Recent discussions among healthcare professionals highlight the potential benefits of incentive-based compensation models. For example, physicians in urgent care settings are being offered bonuses for each patient treated, with additional compensation tied to patient satisfaction scores. This structure not only encourages doctors to see more patients but also enhances their motivation to deliver quality care.
However, as doctors like Elena Fernández caution, while incentives can drive performance, they possess a double-edged quality. A focus on the quantity of patients treated may inadvertently prioritize simpler cases, leading to a disparity in care for more complex patients. Therefore, any incentive scheme must balance the urgency of treatment with patient acuity and the overall quality of service.
Additionally, the development of comprehensive evaluation metrics will be critical. These metrics should consider not just the speed of service but also the thoroughness of assessments and diagnostic procedures. More holistic evaluation criteria may foster a healthier workplace environment and promote cooperative teamwork among medical staff, mitigating potential competitiveness stemming from singular incentives.
Looking ahead, the landscape of emergency medicine may also witness a shift towards enhancing the base salaries of healthcare workers in conjunction with performance-based incentives. As Mario Miranda suggests, making positions in urgent care more attractive will be essential to retain and recruit skilled professionals in an increasingly demanding field.
Ultimately, the integration of structured incentives—focused on patient care quality and operational efficiency—has the potential to transform urgent care practices. As the healthcare industry evolves, understanding the complex interplay between motivation, patient care, and staff dynamics will be critical to fostering an environment that benefits both patients and healthcare providers.