Does physician compensation affect the quantity of medical care provided? My paper “Operating on Commission” claims that the answer is yes. I find that surgery rates increase 78% when patients switch from capitation to fee-for-service specialists.
A paper by Devlin and Sarma (2008) examines a similar question for Canadian family physicians.
This is from an article by Anne Eisenberg in the New York Times:
New tools are being developed that may help harried patients, including those with chronic health conditions, monitor their medications, home tests and other details. The information can then be posted to a Web page that the patient can choose to share with a doctor, pharmacist, friend or caregiver.
Among the products:
HealthVault (http://www.healthvault.com/) by Microsoft lets users upload data directly to their account from about 50 devices, including many blood pressure and heart rate monitors, blood glucose meters and weight scales.
NoMoreClipboard (http://www.nomoreclipboard.com/) can draw data from HealthVault to fill in information in medical forms typically required for an initial visit to a doctor.
TrialX (http://www.trialx.org/) matches patients to relevant clinical trials based on their health information.
In August TheDallas Morning News and the Fort Worth Star-Telegram both ran a curious half-page advertisement by HealthFairTM (a health care screening company based in Winter Park, Florida). HealthFair operates a fleet of mobile screening "Health Coaches" that it parks at destinations around the country. The firm, which is JCAHO-accredited, claims to have performed over 1 million preventive screening tests since its founding in 1999.
Things have gotten so bad in the health care paradise of Canada that a Manitoba radio commentary says Canada should "Solve Canada's Doctor Shortage by Copying European Health Care."
Specifically, it says that Germany, France, and Portugal have 50 percent more doctors relative to their population than does Canada. The Canadian Medical Association estimates that between 4 and 5 million Canadians do not have a family physician. Without a family physician Canadians can access health care only through walk-in clinics or emergency rooms. Some researchers suggest that the Canadian shortages are exacerbated by government payment schemes. Because the government pays a fixed amount for each office visit, primary care physicians maximize their income by providing less comprehensive services and structuring their practices to concentrate on patients with simple problems that require shorter visits. Continue reading Doctor Shortages→