The ACC has an excellent survey team (better -- seriously -- than Gallup polls). The team has a cohort of about 400 cardiologists of all subspecialties, ethnicity, gender, and practice types who have agreed to respond quickly and regularly to mini-survey instruments. We call this group and process CardioSurve.

The June CardioSurve panel questions on preferred and predicted future reimbursement mechanisms revealed that, essentially, depending upon which side of the practice fence you sit (i.e.: Private Practices vs. Non-Private Practices) greatly determines your current compensation source and your ideal compensation source.

Nearly two-thirds (63%) of cardiologists in private practices are currently compensated on a fee-for-service basis (FFS) exclusively; and, similarly, nearly two-thirds (65%) of these private practice cardiologists indicate that their ideal compensation is fee-for-service. Some of this response seems to be related to fear that doctors are due to be shafted regardless of what form of reimbursement is used. Therefore stick with the devil you know -- even if it is constantly declining.

Conversely, more than three-fourths (78%) of the cardiologists who are not in private practice currently receive a salary as their primary source of income.  However, interesting to note is that only 57% of these cardiologists state that a salary is their ideal form of compensation.  Fee-for-service (19%) and a mixed compensation system (22%) actually gain strength among them for ideal compensation. This makes sense. Salaried cardiologists deserve incentives for productivity (everybody doesn’t work as hard) and quality (everybody doesn’t strive as effectively for better outcomes). Incentives have to be based on relevant data comparisons—not conjecture. That’s why the PINNACLE Registry, which can measure individual outputs and performance related to evidenced based care, is so critical.