A recent report by AMN Healthcare, an organization that focuses on health care staffing issues, finds groups are increasingly prioritizing productivity over quality in physician bonus structures. This shift raises significant legal and ethical considerations, particularly regarding the potential risks to physicians’ professional licensure and the quality of patient care.
The rise of productivity-based incentives
According to the report, 66% of physician contracts now include a production bonus, up from 62% the previous year. In contrast, the inclusion of quality metrics in bonus structures has declined, with only 16% of contracts featuring them, down from 26% in 2024 and 31% in 2023. Productivity metrics often focus on:
- Relative value units (RVUs)
- Net collections
- Gross billings
- Patient encounters
While these metrics can drive efficiency, they may inadvertently compromise the quality of care if not balanced with quality-focused incentives. It may be wise for groups to include quality metrics, such as patient satisfaction scores and readmission rates, to help better ensure physicians continue to provide medical care within the bounds of standard of care expectations.
Legal implications of neglecting quality care
The emphasis on productivity over quality can have serious legal ramifications. Physicians who fail to maintain high standards of care may face board investigations, which can jeopardize their professional licensure. Such investigations often arise when patients do not receive quality care, leading to potential malpractice claims and reputational damage.
The findings from AMN Healthcare’s report emphasize the need for private practices and other health care organizations to balance productivity and quality in physician compensation structures. While productivity metrics are a part of operational efficiency, they should not overshadow the importance of quality care. It also serves as a stark reminder for physician practitioners: although the group or organization may be motivated by numbers it is ultimately YOUR license at risk. Make sure your practice is in line with your values and keep proper documentation to support your decisions in the event of an investigation.
Attorney John Rivas is responsible for this communication.
