Paying physicians more to get more -- or to get less

November 28, 2011 in Health

Labour economics can provide a valuable perspective in addressing the supply of doctors and access to care, states an analysis in CMAJ (Canadian Medical Association Journal).

"Understanding and accurately predicting the response of to incentives is essential if governments wish to increase the supply of physician services," writes Brian Golden, Sandra Rotman Chair in Health Sector Strategy, the Rotman School of Management, University of Toronto, with coauthors.

Access to health care in Canada is a challenge in many regions, and while there has been an over supply of physicians in the past, many people currently have problems getting care. "Central to the issue of access is the adequacy of the supply of physicians — specifically, whether the number of physicians and their work effort sufficiently addresses the health care needs of the population," write the authors. "Supply is appropriately managed when there is neither a shortage nor surplus of services."

Provincial and territorial governments can help increase access to care by setting policies that influence physicians to increase their working hours and thereby affect the supply of services they provide. Ironically, by having such a strong impact on hours worked, the authors report that increased pay to attract more physicians can also have the unintended consequence of reducing the hours physicians choose to work.

Governments may provide nonwage compensation such as recruitment or retention bonuses, repayment of tuition fees, relocation support or staffing costs. However, nonwage rewards not linked to hours worked "also reduce the fixed costs of a practice and create a pure income effect, thereby inducing fewer hours of work and fewer services provided."

"Linking compensation to time worked or services provided, as opposed to forms of pay that are unrelated to time worked, will better ensure the goal of increased work hours," the authors conclude. "Policy-makers should recognize that policies for compensation may result in just what we hope for — or just the opposite."

Journal reference: Canadian Medical Association Journal search and more info website

Provided by Canadian Medical Association Journal search and more info website

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ironjustice
Nov 28, 2011

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The government should be training more of our RN's to do more of the jobs doctors normally do like physicals and vaccinations and doctors would be free to do MUCH more work than they are presently capable of doing. The health profession seems to believe since they are a limited quantity and many times suspect in quality they DESERVE to be able to 'name their price' but as has been evidenced previously by Saint Tommy would and WILL have their collective bargaining rights curtailed to the point they will be employed elsewhere than Canada.
rawa1
Nov 28, 2011

Rank: 1 / 5 (1)
The more we will give the people, the more time they will need for spending their money, the less work we'll get.

http://www.youtub...APnuFjJc
ottoezra
Nov 28, 2011

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Doctors work enough and they are under paid, and abused. What other profession would allow for this.
ironjustice
Nov 28, 2011

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"Doctors work enough and they are under paid, and abused. What other profession would allow for this"

This is in Canada ? Doctors in Canada are well paid and are not abused. The majority of doctors deal with people and when one deals with people one is dealing with 'irritable' people. It is beyond me how the medical profession and other people haven't realised patients are prone to anger? If a doctor is abused it is to be likened to someone at the complaint department. Fifty percent of the time the person in the complaint department is abuse BUT that is because the person is ALREADY angry and NOT because the person is necessarily an ahole. If doctors believe they are more abused than normal professions it is because they CHOSE a job IN a complaint department. Imho.
FrankHerbert
Nov 28, 2011

Rank: 1 / 5 (5)
BUT that is because the person is ALREADY angry and NOT because the person is necessarily an ahole.


Actually if you had ever worked in the complaint department (or a service job) you would feel differently. If you're an "ahole" to someone that is trying to help you, you're just an ahole regardless.
ironjustice
Nov 29, 2011

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"If you're an "ahole" to someone that is trying to help you, you're just an ahole regardless."

What say ye then to the study which shows conclusively the lowering of pain WHEN someone swears out loud ? You don't think the active expression of anger therefore LOWERS pain ? THAT would not be relevant to this discussion ? PROOF that a person would endure LESS pain BY appearing to BE an ahole ? Swearing loudly or speaking angrily would amount to the SAME result , relief of pain ?
Nerdyguy
Nov 30, 2011

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"Doctors work enough and they are under paid, and abused. What other profession would allow for this"

This is in Canada ? Doctors in Canada are well paid and are not abused.


Really? Do you know them all?
Nerdyguy
Nov 30, 2011

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Doctors work enough and they are under paid, and abused. What other profession would allow for this.


lol, ALL PROFESSIONS.

I suspect you are very young. Give it a few decades, you'll understand.

Doesn't matter if it's the Church of Caring-for-all-our-Neighbors, or a Chinese child-labor sweatshop (or anything in between). Every profession is filled with people, and people are the same the world over.
ironjustice
Nov 30, 2011

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Another example of people seemingly abusing a doctor would be diabetes. Researchers found a group of people who lived in the mountains. These people had a tendency to blow up / get angry at the slightest thing. They narrowed it down to a blood sugar problem. The fact they got angry normalised their sugar levels. AGAIN proving doctors who believe they are 'unnecessarily' abused are in FACT privy TO part and parcel of their profession. Having signs in an Emergency Ward saying "zero tolerance for staff abuse" is the equivalent of them having a sign "don't bleed". Yeah .. right.
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