The Brave New World without Fee-For-Service

Click the image to find Dr. Parks' blog

Click the image to find Dr. Parks’ blog

In my personal mission to generate, paraphrase or outright steal as many snide, sarcastic, facetious, and/or generally disparaging remarks about the policies and procedures of Medicare and private payor reimbursement, I sometimes find posts or articles that simply cannot be improved upon by my own hand. Ok, it happens more often that sometimes… Anyway, I found a post today that I simply must share, especially because it has many references in it that I find useful, and perhaps you, dear reader, may also find useful. But aside from the links therein, there is an analogy given by the author that is the best I’ve heard.

I quote that analogy for you, below… but you should go read the entire article itself, written by a general surgeon, Jeffrey C. Parks, Chief of General Surgery at Hillcrest Hospital, part of the Cleveland Clinic Health System.

The article, “In Praise of Fee-for-Service” is from Dr. Parks’ blog, and pointedly exposes the lack of logic now rampant in the misguided efforts to fix the American healthcare system, and more specifically, “our broken-down, antiquated, self-interested model of reimbursement for care provided called ‘fee-for-service’.”

This is from the last paragraph of the post, literally dripping with sarcasm:

 “The true test of a physician’s character depends on his or her willingness to forgo personal remuneration for services rendered. All compensation ought to be contingent on the final outcome. Only by disconnecting the physician from any tangible financial benefit will we enter the Utopian era of Value Based, Collaborative healthcare provision. After all, the rest of the economy functions along similar lines. No one pays their plumber to come out to their home for a leaky faucet. That’s absurd. We all pay a set, reasonable premium every year for “Household Expenses” which covers your plumber, heating and cooling guy, roofer, various approved handymen, contractors, etc. And if another pipe, in the other bathroom springs a leak within 60 days, well, that plumber shows up upon demand to fix it sans additional charge. This is how we control costs. we simply stop paying for services rendered. Because physicians are only out to get into your wallet. They will not stop. Without an aggressive counter-attack they will continue to bill you for that 4AM appendectomy, for working up your chest pain, for diagnosing your breast cancer. The world has moved past such depravity. We have arrived at the precipice of disaster and, looking over the edge, a Paradise extends interminably before us. I see a world with only healthcare “providers” rather than the unnecessary hierarchical declination from “doctor” to “midlevel practicitioners”. I see bundled reimbursements and capitation. It is a Brave New World of “Patient Centeredness” and “Accountable Care”. Physicians must fall into place and accept their role as interchangeable pieces, like ever so many Ford workers on a modern assembly line, contributing a small widget to the glorious whole. The new way strides forth with ineluctable momentum, with or without us…. “

Well said, Dr. Parks!  I for one will be watching his blog for more of his unique style and opinions. Find it at

I’d also be very interested in getting in touch with Dr. Parks’ plumber…

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One Response to The Brave New World without Fee-For-Service

  1. Pingback: U.S. Senate Committee blames providers for appeals backlog | Appeal Academy

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