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Village MD: A Potential Solution to the Doctor-Patient Prisoner’s Dilemma

In the media today, it seems like there are two groups of people in the field of healthcare that constantly clash against each other, like a bitterly-married elderly couple trying to out-shout the other spouse, and they’re known as patients and doctors respectively. It seems like we all hear stories from our daily lives or the media that chronicles the disparity between the priorities of what one group wants and what the other group wants. Patients hurl accusations at doctors for ordering needless tests for profit, while doctors contend that the tests were necessary to avoid liability. The constant criticism of what’s being done wrong instead of what should be done to correct the problem ultimately erodes the quality of care that a patient receives and the ability of doctors to provide the care that a patient deserves.


Just why is it that doctors and patients can’t make peace with one another and work together to solve this problem together instead of conflicting needlessly? Perhaps it’s because each side has its own story with their own morals to tell, and the ultimate desire to tell their own side of the story is what’s eroding the patient-doctor trust and the quality of care that the patient receives (a situation in which neither side benefits). This is a clash that is only made even more pronounced with the recent trend within the healthcare industry from a fee-for-service model to a value-contracting model, essentially removing the incentive for doctors to run more tests for profit (and not necessarily for the benefit of the patient) and replacing that system with one that rewards doctors for giving “better” healthcare based on a set of criteria established in the contract.


However, what should be a change towards better healthcare and lower health costs is actually brought down by the fact that most contracts evaluate doctors with healthcare satisfaction surveys filled out by patients after receiving care. From this, a form of doctor-patient prisoner’s dilemma appears, where doctors are given incentive to provide a short-term solution to a patient’s problems rather than to treat the patient properly. If a patient comes in demanding a certain treatment to their perceived problem, it is almost always in the interest of the doctor to proscribe the treatment being demanded regardless of whether it would be beneficial (or detrimental) to the patient lest they receive a negative response on the patient survey (a situation in which the doctor always loses out). This is the dilemma that doctors (and patients) are finding themselves in, where patients are given short-term treatments instead of receiving quality care by physicians hamstringed by the surveys where they are practically incentivized to cave into the demands of their patients. The doctors find themselves forced into a dominant strategy of providing the treatments demanded by the patients (rather than what’s best for them). The lack of a proper system in place to prevent this prisoner’s dilemma stops doctors from truly providing quality healthcare to patients, and simply results in inferior healthcare in the long run. The field of healthcare is always changing however, and the basis of value-based contracting remains a viable alternative if done right.


VillageMD Model of Care

VillageMD Model of Care



A possible solution to the doctor-patient prisoner’s dilemma comes in the form of a startup company known as VillageMD, a platform created with the purpose of assisting physicians thrive in value-based contracting and streamlining the process of treating patients so as to allow physicians to build closer relationships with patients to work on a quality treatment that satisfies both doctor and patient. By avoiding the pitfalls of relying solely on patient-based surveys to determine quality of healthcare, VillageMD provides a service that allows physicians to make data-driven decisions in providing better healthcare at lower costs to the patient, and creates a culture that promotes strong relationships between patient and doctors with a financial and care system that supports it. The doctor-patient prisoner’s dilemma is a problem that can be solved by offering a new outlook on the doctor-patient relationship paradigm and resolving the conflict with alternate methods of evaluation of the quality of care provided by a physician.


Source Links:

VillageMD Empowering Physicians To Focus on What Matters Most

Community Health Network partners with VillageMD to form new company and deliver innovative primary care model in Indiana

How the doctor-patient relationship has  become a prisoner’s dilemma

The Key to Transitioning From Fee-for-Service to Value-based Reimbursements


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September 2015