Quote:
Originally Posted by acottawa
It is an incredibly inefficient system to have individual doctors renting their own office space, paying their own staff, buying their own equipment, etc. It might have made sense 100 years ago when people lived in small towns but makes no sense in a very urban country.
I don't mind paying doctors more, but it should be going into their pockets to encourage them to go into family medicine or to not leave the country, not to inefficient overhead.
|
Multiple payment models for physicians already exist.
Some physicians are salaried, notably pathologists, laboratory physicians and public health officers. These positions come with full benefits and pensions. It should be noted that practitioners in these specialties tend to retire at the first possible opportunity.
In addition to fee for service, other payment options for contract physicians include capitation and sessional fees. Capitation usually means getting a stipend for each patient in your practice. As such, the younger and healthier your client base is, the more people you can have in your practice, and the more money you can make. As such, physicians who choose capitation are penalized for looking after the sick and the elderly.
The latest trend is for primary care physicians to band together in a group practice, potentially in a multidisciplinary clinic also staffed by NPs, pharmacists, physiotherapists and possibly social workers. They look after the patients as a group, and, if you want time off, then one of your colleagues will look after your patients in your absence. I think this is a good idea, and, by working in a group setting, this can reduce your individual overhead.
Group practices like this work less well for most specialists, because there are usually only a small number of physicians in each specialty in any given city.
Could we just put all primary care physicians under a salary arrangement and be done with it?
Most doctors would not like this. If we were employees, then there would be rules that could be burdensome. In particular, many young physicians do not want to destroy their lives like the current group of retiring physicians did. Most younger physicians (especially women who make up more than 50% of the workforce of younger GPs) work reduced hours, or, on a part time basis to prevent burn out, and to spend more time with their families. If they were state employees, would they have the freedom to do this?
Also, salarying physicians would almost certainly cost the government more money than the current paradigm. All expenses would be paid by the government, and, full benefits and a pension would be paid. I guarantee you that the cost of the health care system would balloon.
Prev
Linear Mode
