Leslie,
I can understand totally your frustration. It is extraordinarily distressing to be part of a system in which one is never reimbursed for simply doing the right thing.
The entire MU/"Quality" game strikes me as being a giant game of Whack-A-Mole. As long as anyone feels resentment that they are not appreciated for being moral and professional but for doing "stuff" (whether it be a procedure or clicking all the right boxes, like some sort of rat in an experiment), then the system will continue to be subverted. "OK,", I'd think, "You want to pay me only if I have noted down if a patient is Black Hispanic or White Hispanic, and all the little boxes are filled? OK. that's what you get. That ALL you get."
I maintain that the only way to fix this is to decouple personal income from the specifics of day to day activities. Pay all physicians a flat salary, independent of specialty, no little check boxes, and count on peer pressure to get us to do the right thing. I maintain that the non-financial rewards of doing the right thing will modulate activities once the economic rewards are eliminated. I was really proud when I was accepted to medical school. I think maintaining that pride is a powerful motivator.
