Cognitive services

A term applied to all the activities of a physician (or other professional) other than the performance of procedures. The charges of physicians are relatively easy to explain in surgery and other instances where “something is done” to the patient. High charges for, say, diagnostic evaluations, patient and family counseling, and the care of patients with infectious diseases, are much harder to explain, and thus charges are considerably lower. “Cognitive services” require as much time and skill as surgery. However, much of this effort and skill is simply not seen by the patient or payer. Nonetheless, an education as long and arduous as the surgeon’s may be required, as well as unseen time in the library and informal consultation with colleagues. Efforts to overcome the resulting perceived inequities in payment have led to the labeling of non-procedural services as cognitive (intellectual). No term for “non-cognitive” services seems to have appeared.


 


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