3 ms·

"He was taking advantage of peculiarities in OHIP’s billing system, which encourage all sorts of chicanery that, while not always illegal, can tempt doctors int

by wolco 7y ago

"He was taking advantage of peculiarities in OHIP’s billing system, which encourage all sorts of chicanery that, while not always illegal, can tempt doctors into bending the rules" This explains a lot. If you have two issues they really do make you book again. They send you for unneccessary tests and refuse necessary tests. Everything is setup to beat the system. What you really need (medicine wise), getting better, safest choices are not really part of it anymore. I think Ontario needs to move away from fee based billing. It seemed like a quick way to inflate how many people have a family doctor. Doctors see more people but appointments are 10 minutes of less. Pay doctors an annual salary and force them to work for the government as an employee and impose standards with customer service in mind.

waterside81 7y ago
Ontario isn't 100% fee-for-service. GPs are capitated, they are paid by how many patients are enrolled on their roster. It's the specialists who are paid fee-for-service - but yes your point stands, perhaps its not the best model as it incentivizes this sort of chicanery.
adolph 7y ago
In what industries or occupational areas has forcing people to work for a particular entity and imposing standards on them improved quality and/or efficiency? Many in healthcare see fee for service giving way to value based care but it isn’t a simple knot to cut. http://www.hl7.org/about/davinci/index.cfm http://www.hl7.org/about/davinci/index.cfm
- wolco 7y ago
  Fee for service increases the amount of services performed. On the surface that provides additional value in terms of more services performed so greater coverage with fewer doctors. That goes against the government who may want to limit the number of services because of budgets. So services not under government watch are over ordered and services under ration are underordered. On the patient side you are not getting the best medicine you are getting medicine that pays the most fees.

by wolco 7y ago

waterside81 7y ago

Ontario isn't 100% fee-for-service. GPs are capitated, they are paid by how many patients are enrolled on their roster. It's the specialists who are paid fee-for-service - but yes your point stands, perhaps its not the best model as it incentivizes this sort of chicanery.

adolph 7y ago

In what industries or occupational areas has forcing people to work for a particular entity and imposing standards on them improved quality and/or efficiency? Many in healthcare see fee for service giving way to value based care but it isn’t a simple knot to cut. http://www.hl7.org/about/davinci/index.cfm http://www.hl7.org/about/davinci/index.cfm

wolco 7y ago
Fee for service increases the amount of services performed. On the surface that provides additional value in terms of more services performed so greater coverage with fewer doctors. That goes against the government who may want to limit the number of services because of budgets. So services not under government watch are over ordered and services under ration are underordered. On the patient side you are not getting the best medicine you are getting medicine that pays the most fees.