of doctors and money…yup it’s a health policy post

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From the plastic surgery Almodovar film The Skin I Live you think she looks a little freaked out because of her doctor's fees?

I just finished one of those gosh-darned one-year masters programs in London, where they pack it all in and really hammer it into you.  You’d think that since I’m on vacation in my wonderful hometown, I’d probably take some time to smell the roses and shawarmas, but no, apparently my mind is still on it.

And so, over reunion drinks the other day, conversation wandered over to our professional realms and I asked one of my best friends from university, now a doctor, what she felt about how doctors should be paid.  I’d written a paper on the topic a few months earlier and I really wanted to know what the doctors thought about it themselves…and you really hit it on the nose – putting together personal preferences, different specialisations and a whole gamut of other factors into the mix of what affects physician payment systems.

And then this article came out in Health Affairs on the issue of doctors fees as a primary factor in driving up the cost of health care in the US.  You can read NYtimes’ take on it here, and the whole article here.  It’ll be interesting to see the impact of this study, and it’s author’s work as Assistant Secretary of Health and Human Services in the journey towards better health care reform in the US.  Moreover, it might be interesting to check out any effects on neighbouring countries as well since Canada’s own medical associations have similarly faced the blame of driving up the cost of care through increased fees.

So, this begs the question of the paper that I wrote this year…is there any other way we can pay doctors to achieve an efficient system that saves money and still produces quality care? How can all those extra costs get nipped and tucked? (sorry for the pun!)

PS – The Skin I Live In, Pedro Almodovar’s latest flick, is showing at TIFF this year but I had the opportunity to watch it in London.  It’s an amazing, beautiful movie and quite literally a mind-fuck (pardon my French).  So maybe….it really is those doctor’s fees?

PPS – More food for thought: The president of the American Medical Association responded to Sherry Glied’s article here in the NYtimes.


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