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October 26, 2005

Antibiotic Prescribing for Lower Respiratory Tract Infection—Reply

JAMA. 2005;294(16):2032. doi:10.1001/jama.294.16.2032-b

In Reply: I appreciate Dr Stapczynski’s comments and do not discount the perverse impact that poorly designed patient satisfaction surveys linked to “pay for performance” plans may have on physician behavior. He states that the 14% absolute difference in satisfaction “may appear small to an academic physician.” Perhaps, but while I have an academic appointment at Michigan State University, I see patients 3 days a week in a small private practice, where my income depends completely on how many patients I see and whether they pay their bills. To paraphrase a recent president, I feel his pain.