Primary care doctors need financial independence

I’ve often given doctors too little credit when it comes to business decisions.

But, in an op-ed published at Reuters, physician Ford Vox argues otherwise.

He notes that doctors, indeed, have tremendous business sense:

How can anybody say that doctors don’t have business sense, when not only do most American physicians forge their way in small private practices, but new doctors lay their cards on the table every year? The competitiveness of residencies, where doctors train to become a pediatrician or a cardiologist, correlates strongly with the field’s earnings potential.

Insurance companies usually intercede when it comes to financial transactions between doctor and patient.

Instead, why not let doctors have more control over health care dollars, instead of wonks and administrators who have little clinical experience?

Health insurers use nearly one-third of premiums before spending on health care delivery. Dr. Ford contends that “it’s time to boost the rank and responsibility of primary care physicians by handing them the source of insurance company power – the money.”

Government officials and health insurers pay constant lip service to the importance of primary care. The only way to truly back up their words is to ensure primary care has the adequate financial resources and independence to do its job properly.

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  • Vox Rusticus

    Not just primary-care doctors, Kevin.

  • GlassHospital

    I think as docs until we can reach some type of collaborative consensus on actually using resources more prudently/efficaciously, letting us have the keys to the medical car would not be in the taxpayers’ best interest.

    I speak for myself, but no doubt loads of other PCPs, that for individual patients we always want to do what’s right and what’s best. And in a consumer-oriented culture, that means ordering. Lots of stuff. Even when the evidence is against it.

    I agree with the post in theory, but I think in practice it’s a non-starter.

  • ninguem

    Didn’t the Brits do something like that a few years back?

    I think the term was “fundholder”, something like that. The GP controlled where the patients funding was going, when sending off for specialty care.

    What became of that?


    Vox rocks! What he said.

  • Edward

    The devil is always in the details. I agree in principle. A system where primary care physicians decide on where to spend our money would make more sense than the current antiquated system where we are unable to get away from overpaying for many procedures and tests. Which primary care doc make these decisions, how, collectively decide, pick a few representatives? The details would be difficult, and the exisiting political power of specialty associations will be very difficult to convince on this one. Forget about talking insurance compaines out of their tithe.

  • BobBapaso

    So, how do you give the money to the PCPs? Give it to the patients first by allowing them to have untaxed health care savings accounts financed by automatic contributions like payroll withholding. Then patients and their doctors can decide for themselves what possible benefits are worth the risk and the money.

  • Pamela Hewett

    I’ve worked with physicians of all types for 13 years as a provider of financing for equipment and their business as well as patient financing. I’ve seen Dr’s primary care be limited by insurance companies low payout to physicians. They create an atmosphere of fast service and limited abilities to truely spend time evaluating the patient. Most Dr’s I know would like more time and better pay to treat their patients. Would a public option help, I think so. The insurance companies don’t help the equation. To post comments or keep up to date on finance issues go to Thanks Kevin for the great site.

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