Physician Payment - Doctors Vindicated

In John Goodman's Health Policy Blog, August 29, "Doctors Vindicated," Doctor Goodman, PhD, a conservative economist who founded the National Center for Policy Analysis in Dallas, says there are two schools of thought about what's wrong with modern medicine.


1) Doctors are at fault.

2) The payment system is at fault.

Most commentators, including many doctors, he claims, belong to the first camp. Doctors, they say, are stuck in a rut and refuse to use computer, work in teams, and deploy all of those best practice protocols. Goodman disagrees. He asserts doctors are just like other professionals. They respond to economic incentives.

Goodman uses dermatologists as an example. They practice two kinds of medicine: 1) that paid by third parties; 2) that paid in cash for cosmetic procedures.

Patients in the first camp face long waiting times, shoddy reception rooms, and often are seen by nurse practitioners and physician assistants. Patients in second cmmp receive prompt treatment by the doctors themselves, have multiple options, have short waiting times, and are often seen in luxurious settings.

According to Goodman,

1) People in the first camp want to figure out and to dictate how medicine should be practiced and to pay doctors only if they doctors do it the right way, the 3rd party way.

2) People in the second camp want to liberate doctors to make continuous improvement and to financially benefit from that improvement.

To which camp do you belong?