Do doctors get paid for every patient seen in the emergency room? “Incentives”

The emergency room is the gateway to hospitals. Reducing waiting times is therefore a key pillar for both public and private healthcare companies as fast and efficient care is crucial for patients to feel comfortable and well cared for.

Each person and each disease condition must be treated individually, as some patients need tests, others only consultation, and some require prolonged monitoring for hours or even days. Likewise, the seriousness of each episode must be taken into account.

However, what hospitals do take into account is the time it takes for people who come in with a health problem. Register and undergo screening and examination by a doctor for the first time.

The patient’s goal is to be seen by a doctor as quickly as possible, and therefore, health center management has sought to find different ways to motivate professionals to see more patients during their shifts.

One of them is Add an incentive for every patient seen. To the salaries that come to them regularly every month. In this way, the more patients are examined, the more money the doctor gets.

Mario Miranda, MD Emergency cases At QuirónSalud Madrid Hospital, they explained to Medical Writing the financial incentives they receive at the health centre in order to reduce waiting times and see more patients during their shifts.

The doctor commented that they receive one euro for each patient examined and that this amount is doubled, at the end of the month, according to the NPS scale, which are the evaluations made by patients who respond to a survey sent to them by email a few days after they go to the hospital.

“Our incentive is 1 euro for every patient seen. Miranda explained that this is multiplied by the NPS scale by one, two, three or four at the end of the month.

Therefore, to this fixed part of one euro per patient, we must add the scores that each doctor receives for the treatment provided to the patient. These ratings range from 0 to 10.

In this vein, the emergency physician highlighted that incentives “It is necessary for doctors to be somewhat more motivated. “This helps.”

“Incentives have been shown to be one of the factors that help reduce waiting times in emergency services, but they are a double-edged sword,” said Elena Fernandez, an emergency physician at HM Rivas University Hospital. “They must be prepared by identifying the different elements that will be awarded to them very carefully.”

“One area that needs to be evaluated, of course, is the time to see patients, ensuring that waiting times can be reduced, since all team members will want to see more patients. But this is where the special care needs to be, patients with more trivial illnesses and more complex patients come to the emergency room and are seen and treated more quickly. If a doctor sees only this type of patient, he will see more people than another doctor who treats more complex diseases.“Fernandez added,”

“This is why incentives should not only focus on the number of patients treated, but also on the quality of reports, the type of patients examined, and the number of tests,” HM Hospitals Group doctors pointed out.
Requesting additional services, for example.

Miranda, who has worked in other centers, noted that this is not the first time he has encountered these incentives and gave the Torrejón hospital as an example.

“When I was in Torrejon Hospital, there were incentives. A small amount was collected from each patient seen and then collected based on the severity of the patient’s condition. It varied depending on whether they were classified as green (mild), yellow (moderate), or orange (severe).

On the other hand, the doctor Emergency cases He suggested new ways to encourage doctors. “It’s all about making it more attractive and a good option, apart from incentives, might be to raise the basic salary of doctors because there is a shortage of emergency professionals and either it becomes more attractive or it will be harder to find people to do that ‘job’.”

“There were no incentives in any of the positions I was in,” Fernandez noted, but added that they were included in the positions he knew of. It is “economic rewards for every patient seen.”

“Incentives are necessary to motivate doctors to some extent.”

Finally, Miranda noted that incentives get doctors to see more patients and have lower emergency room wait times, but noted that in some cases, it can create an environment of “competition” that doesn’t usually sit well among colleagues.

“There is everything. With incentives, you force yourself to participate more, to see more patients. It is true that there are certain places that if one monopolizes them too much, there are colleagues who may feel a little bad but are fine, I would say the one who He encourages Emergency cases Improves and does not increase waiting times.“He pointed out in this regard.

For Fernandez, the “extras” for each patient seen can lead to a competitive environment, but he added that the emergency coordinator is key to ensuring that doesn’t happen.

“The presence of incentives in general will create a competitive environment within the team.But I think the role of the service coordinator plays a fundamental role in this aspect, and if it is not only dedicated to waiting time, but, as I said before, other aspects of the quality of care are evaluated, it can generate healthy competition in the field, he commented, “and the main benefit is the patient.”