Someone asks Dr. Rob: “Why do doctors fight universal care so hard when they get a worse deal from the insurance companies than European doctors get from the governments?”
He gives a few good reasons, but this one probably resonates with most doctors:
If I am lazy, I earn less money. If I work hard, I earn more money.
Ah, the American way. Of course, this cuts both ways as the current system encourages physicians to do more, despite evidence that more medicine isn’t necessary better care.
Putting doctors on strict salary won’t work. Like Dr. Rob, I’ve worked at the VA as well, and patients suffer if there is little motivation for doctors to be productive.
I’m not sure what works the best. Probably a base salary with bonuses for both outcomes and productivity. The performance measures would have to be implemented thoughtfully and carefully, or else a whole new can of problems will arise.
Related posts:
- Physician compensation: Salary vs productivity-based
- Socialized medicine stories: NHS supervisors have a financial incentive to cut patient services
- Patients do not want their doctors paid on salary
- Why it’s difficult to put doctors on a salary
- Where’s the money to better pay primary care doctors going to come from?
- Staying human
- The VA is not immune to executive bonuses
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Of course, there’s no reason a universal health care system couldn’t and shouldn’t pay doctors appropriately for output and outcome. So, how could that be a reason to be against it?
Yeah, I’m going to trust the government who has been trying to cut the salary of physician for 7 years in a row. When asked why they say because a formula made me do it! What accountability. They cannot defeat the formula and act as if they bear no responsibility. Let’s just give them virtual monopoly and see what they do to the salaries of physicians.
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