How MIPS and other Acronyms Devalue Our Work As Physicians

MIPS or Merit-Based Incentive Payment System has become a topic of discussion recently, and it's predicted to have a significant impact on the income of physicians who currently see Medicare patients. It's a new payment system that will provide annual salary updates to physicians based on four "performance indicator" categories: quality, resource use (efficiency), clinical practice improvement, and meaningful use of EHR. What they have essentially done is combine the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VM), and Meaningful use into one program. Now according to most sources, MIPS doesn't apply to everyone, however since the trend is to take Medicare as the standard, it could be predicted that soon you will see other payers (and whole health care system) begin to default to this payment model or something similar sooner or later.

How MIPS, MACRA, and other Acronyms are Creating A New Social Reality for the Value of Physicians

There was a time when our worth as physicians was not tied to the number of tests we ordered (or did not order), how many patients we saw, or when we closed our charts. It was more tied to the quality of our actual care (as determined by clinical outcomes), and the relationships that we built with our patients. Over the years, the attempt to create standards of care (which I do believe was an attempt at improving the system), has morphed into somewhat of a dictatorship run by insurance companies, government officials, and healthcare executives that are driven more by money than the welfare of patients.These entities treat medicine like it's a cookie cutter process while we know that patients are individuals and there has to be some variation in care from time to time.Furthermore, the parameters for "efficiency", "quality", and "meaningful use" are created by high paid executives that are not on the front lines of day to day medical care. They have no clue about the actual clinical atmosphere of daily practice.They arbitrarily set these parameters based on data sets that are not necessarily reflective of the true day to day operations practice.

As a result, we are being forced into a "work more, earn less" model, and this is, in part, what is ultimately driving us women and physician moms to burnout earlier and earlier in their careers. The decreasing reimbursements and resulting decrease in salary and income potential that is happening creates an additional burden when we still have to deal with the hundreds of thousands of dollars we spent getting this education.

So how do we deal with this? The truth is we have little power over what the "powers that be" are doing, but we have control over how we approach our careers given the environment. Early Financial planning and investing, realizing the value of our credentials beyond clinical practice, and considering additional sources of revenue is going to become the key to reclaiming our power (and value) in this industry. At this point, sitting around waiting for "the system" to come to its senses and change is a set up for career burnout (https://stressfreemommd.com/career-fulfillment.html) .

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