How Doctors are Paid: A Calorie is not a Calorie

SS18080The more doctors you have in your area, the higher the cost of care. That is the case for many US cities according to Dartmouth Atlas data.


Some states are addressing this problem by what appears to be the “calorie is not a calorie” rule. Except in this case it’s more like, “a doctor is not a doctor.” It turns out if you add more primary care doctors to an area, you can maintain high quality care coupled with low costs. This has been proven so far in Minnesota, Wisconsin and North Dakota. According to a special report at Reuters, the goal of these states has been to use primary care doctors to “keep patients healthy and out of hospitals.”


One problem noted in this Reuters article is the current “fee-for-service” payment system in this country where specialists are rewarded more for their procedures than primary care doctors are for preventing the disease in the first place.

These studies are providing mounting evidence that throwing money at the problem is not the answer. However, as an alternative, consideration could be given to redistributing the way health care is delivered in this country. For now, health care reform focuses more on access to care which has been a pressing issue. I’m just hoping that next on the agenda might be incentives for increased primary care. But of course, primary care may be like the stepchild in this story, put aside yet again while another national catastrophe takes priority.


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