Healthcare systems are big and complex beasts, that are very hard to transform overnight. In the United States, for example, we have long had a system of care dominated by fee-for-service payment. In this kind of system, the more tests and procedures and office visits that a physician orders, the more that physician gets paid.
A little over 10 years ago, fee-for-service also dominated primary care practice in Ontario, Canada. You can see that with the light blue area in the circle on the left. But look what is happened in the past 10 years! System has dramatically shifted away from fee-for-service. And guess what? Primary care physicians in Ontario have greater job satisfaction than they had a decade ago.
If you want to read more about this transformation, check out the article by Brian Hutchison in the April edition of Health Affairs.
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