The Health Department outrages primary care physicians with the proposal of an incentive for discharges
The measure appeared in a document that is not final and the ICS has already discarded it.
BarcelonaAbsolute rejection by all primary care representatives of the measure proposed by the Catalan Health Institute (ICS) to grant financial incentives to doctors who process discharges for patients referred by mutual insurance companies. Colleges, scientific societies, and unions reacted this Monday against the proposal, which ultimately came to nothing after the ICS backed down. "There will be no objective designed to incentivize doctors to increase the number of discharges," stated sources from the company after the uproar.
Although the ICS has already backed down, it has not prevented unrest among primary care physicians. The measure was part of a package of possible variable productivity supplements (DPO), which for 2025 are still "in the process of being defined." According to the ICS, "work is being done on objectives that ensure patient support during their recovery" and they are not yet final, but the measure in question has been put forward. The morning of Catalunya Ràdio before the document was closed.
The sector's response was swift. Jaume Sellarès, vice president of the Barcelona Medical Association (COMB), explained to ARA that they would not understand why public health would encourage "an action that could be detrimental to the patient's health" and welcomed the fact that the ICS (Spanish National Institute of Statistics and Census) understood the discontent generated and withdrew the proposal. Even so, the professional association believes that short-term sick leave must be addressed so that they are not always the responsibility of doctors and, thus, they can dedicate more time to care.
The Catalan Society of Family and Community Medicine (CAMFiC) has also criticized the measure. In a statement, the scientific society urged "family medicine professionals not to accept these indicators as valid or clinically justified" and asked directors and heads of primary care centers (CAPs) not to accept or promote these practices. Finally, they demanded that the Catalan Health Service and the ICS protect the clinical autonomy of professionals.
"Against the code of ethics"
The primary care secretary of Doctors of Catalonia, Lourdes Franco, criticized the measure in a statement to ARA. "They can't financially reward professionals with a measure that goes against the code of ethics," she argued. She believes that pressure from various industry representatives was the reason the ICS ultimately backed down on the proposal, which she considers to have been done in a "sly and perverse" manner.
For UGT, too, the measure "represents economic pressure and coercion for primary care professionals," since if it goes ahead, they would be "forced to make medical decisions influenced by financial incentives." For all these reasons, the union warned in a statement that there is a risk of creating "a perverse model that casts doubt on trust in the public healthcare system and endangers the health of workers," as there is a risk of "releasing patients" who have not recovered.
