Another Pay for Performance Fiasco in the Making

While we Floridians slept last week, our esteemed Florida legislature was passing a bill, SB 6, which effected a major change in how teachers in the state would be paid. Florida physicians were watching the situation very closely. Gone would be the security of tenure, and those seeking to advance their careers by furthering their own education would not be guaranteed higher salaries, let alone the security of keeping their jobs. In other words, teachers were going to be paid based on pay-for-performance. Now most of us would agree that teachers who are able to educate our children in a positive manner deserve to get raises; however, the teachers, for the most part, are strongly opposed to it.

Sound familiar to many of you physicians out there? Many insurance companies are trying to compensate doctors and promote them to their clients (our patients) based on how well we perform in maintaining and improving our patients’ health. I would suspect that many teachers wouldn’t disagree with that doctors who do well get paid more; those who don’t…well, they just don’t want to see anyway, and certainly shouldn’t be compensated as well.

The state of Florida plans to come up with some standardized tests to measure how well a teacher is doing his or her job, at a cost that the state can ill afford. Insurance companies have devised their own arbitrary formulas for calculating the same for doctors. Teachers maintain that they can be teaching in classrooms where students are not motivated, may just be trouble makers, and couldn’t care less about learning and advancing, or teachers might just have students in special education classes who are difficult learners, and although the teachers may have great satisfaction in teaching them, their outcomes could negatively affect the teacher’s income. In response to this new legislation, teachers are threatening to leave the state.

Doctors also complain that they may take care of high-risk patients, or patients who may be non-compliant, and thus adverse outcomes will adversely affect income. This does not bode well for the medical profession… or teaching profession.

Governor Charlie Crist has said he is studying the teachers’ situation and may veto the bill. If he doesn’t, the influential teachers could certainly have a negative effect on his already fading senatorial campaign against Marco Rubio.

And we doctors have to fend for ourselves in another seemingly never-ending battle.