Ordering aspirin tied into a part of ER MD salary ??

CrunchRN, ADN, RN · Aug 18, 2011

Naw, probably his pay is tied to how much he follows current standard of care type stuff. Probably an effort to see that Md's stay up on the latest evidence based medicine and that patients reap the benefit....

MassED, BSN, RN · Aug 18, 2011

this is a brand new attending.... made me think that if they don't follow certain protocols, are they not remimbursed appropriately? Do insurance companies follow, for instance, a CHF protocl/accepted standard of care? Then what would the point be of practicing medicine..? Wouldn't all docs start ordering just to cushion their salaries....??

gonzo1, ASN, RN · Aug 18, 2011

You would be amazed to find out the many hands that dictate what a doctor has to do now. They do have to follow quidelines or see their salaries go down. Insurance companies and hospital admin do dictate a lot of their practice.

OldNurseEducator · Aug 18, 2011

Naw, probably his pay is tied to how much he follows current standard of care type stuff. Probably an effort to see that Md's stay up on the latest evidence based medicine and that patients reap the benefit....

I think the OP is missing the point of the above reply. Keep in mind that aspirinn would be part of the CHF protocol. All doctors should follow a certain STANDARD for every CHF patient, no matter how they get paid! :nurse:

rn/writer, RN · Aug 18, 2011

Hospitals are now evaluated on how quickly (and if) they administer particular treatments. They have a list of benchmarks that go with each diagnosis and keep track of how well the facility is jumping through those hoops.

For example, they want the door-to-cath lab time to be so many minutes or less for chest pain and administration of aspirin for possible MI to be higher than a certain percentage.

I'm sure the new docs are getting pressure from the old docs (who, having the medical basics down pat, may find it easier to take these additional expectations in stride) because the numbers affect all of them when it's time to look at getting a raise.

Several years ago, the unit where I work came in under the approved numbers for something and it really put a damper on our yearly evals. The entire unit felt the sting and it hasn't happened since.

nursej22, MSN, RN · Aug 18, 2011

Aspirin is part of core measures for acute MI and CHF as established for the Centers for Medicare and Medicaid Services.

Following core measures (which are based on scientific evidence) is a measure of quality for healthcare facilities and a requirement of reimbursement.

Aspirin seem like a simple thing but it is very effective in reducing mortality and morbidity.

June55Baby · Aug 18, 2011

Ordering ASA for AMI patients (not CHFers) is probably tied to Core Measures or the Value Based Purchasing (VBP) Rule from CMS, which impacts Core Measures and HCAHPS (Patient Satisfaction). Using VBP, CMS will redistribute funds to participating hospital depending on performance in Core Measures and HCAHPS. So CMS will pay you more for doing well with the Core Measures.

One of the Core Measures is ASA on Admission for AMI patients. Since complying with Core Measures impacts reimbursement from CMS, many hospitals use Core Measure performance on a physician's contract / salary. The more you comply with Core Measures, the more $$$ you get!

applewhitern, BSN, RN · Aug 18, 2011

Yes, I agree with the posters who stated aspirin is simply a core measure that should be met; all this ties in with hospital reimbursement. In the long run, it can affect your salary, too!

rn/writer, RN · Aug 18, 2011

Yes, I agree with the posters who stated aspirin is simply a core measure that should be met; all this ties in with hospital reimbursement. In the long run, it can affect your salary, too!

very good point!

RN1980 · Aug 18, 2011

its called core measures.

SeeTheMoon · Aug 19, 2011

So what happens if the patient suspected/feared MI and took aspirin on their own before admit? Would documentation of such be sufficient to cover fannies?