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May 1998

Capitated Care—Reply

Arch Ophthalmol. 1998;116(5):699-701. doi:

In reply

I stand by my original premise that the moral enterprise between a physician and patient should be independent of the reimbursement method. To suggest that the opinion of an officer of a company that is attempting to create an efficient integration of eye care providers and who capitation revenue represent less than 10% of the company's revenue be disqualified forces us to ask ourselves: Should we discount the opinions of physicians who opine on a specific drug or agent because they receive financial support from pharmaceutical companies? Should we ignore new procedures that are promoted by a physician who earns income from these procedures? Dr Van Buskirk also confuses the cost-effectiveness of annual dilated pupil examinations in patients with diabetes with the study on routine dilated pupil examinations in asymptomatic patients as reported in the ARCHIVES.1 Dr Van Buskirk describes anecdotal information from his market that represents real abuse of a capitated system. In my opinion, different abuses were, and still are, present for those patients who remain under a fee-for-service system in the Portland market.

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