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In Ontario doctors were allowed to switch to capitation, where they receive a lump sum for each patient under their care, rather than billing per service. My p
by Ensorceled 13y ago
In Ontario doctors were allowed to switch to capitation, where they receive a lump sum for each patient under their care, rather than billing per service.
My personal physician loves it, he no longer wastes time filing for OHIP payments and no longer worries that maybe he is only ordering procedures to make more money rather than for a legitimate purpose.
This is a particular problem when diagnosing problems, is "your gut" or "your greed" telling you that the patient needs this $1000 test.
- angersock 13y agoGiven how long the billing process is over in the US, that makes a whole lot of sense actually.
- CaveTech 13y agoCouldn't it then be argued that the doctor is incentivized to give short simple treatments so he can work with more patients?
- gcb0 13y agoIneffective treatment is visible. The discussion is about cheap effective treatment vs expensive effective treatment.
- stonemetal 13y agoWhat would be wrong with that scenario? Shorter, simpler treatments sound like a win for both patient and doc. They wouldn't necessarily be cheaper than long, complicated treatments but on the whole they probably would be.
- CaveTech 13y agoBecause it doesn't imply that the treatment is successful. If I have a condition or disease it could be misdiagnosed as something much simpler and go unnoticed by me for years. Maybe it's not debilitating but that doesn't mean it can't be cured or managed better. When/how do these errors get caught? I'm sure many never are.
- stonemetal 13y agoA long, expensive treatment implies success? I would much rather my misdiagnosis cost 5 dollars than 5000.
- Ensorceled 13y agoSure. But then I'd incentivized to find a doctor who knows what he is doing. I'm ok with incentivizing less medicine rather than unneeded surgery :-P
- haldujai 13y agoCapitation is only viable for primary care physicians which is not what the OP is about. You can't pay surgeons, radiologists, and most specialists a per patient fee because they don't have a consistent patient base. Also their patients vary wildly depending on their disease, this is not the case for PCP. Capitation also has it's own perverse incentives, you are motivated to work less, spend longer with each patient (beyond what is appropriate, such as shooting the breeze with patients) and take more breaks. It is almost as bad as giving physicians a flat salary, you don't promote efficiency, turnaround, and accessibility. Capitation is ideal for the individual patient provided they can get an appointment, but is bad for the system overall. Medicine is primarily concerned with the well being of the general population rather than an individual.
- Ensorceled 13y agoWell, except then you go to another doctor if you are getting bad service. They get paid by patients under their management so if they are taking breaks that can't manage that many patients.
- ars 13y ago> You can't pay surgeons, radiologists, and most specialists a per patient fee because they don't have a consistent patient base. Sure you can. You just go way larger. To entire cities, or counties. It doesn't cover travelers, but you could have bilateral exchange agreements with other municipalities.