Quelle Surprise?

In 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time.
Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid.

Now the article and researchers are quick to point out that causation is not proved, but…

This isn’t an unknown effect. Doctors who get paid more for surgery are more likely to perform surgery, even if non-surgical alternatives are considered a better idea. If they own a share in the institution doing the surgery, even more so.

I don’t like to get down on opiate prescribing, because I think the larger problem is all the doctors who won’t prescribe them. Even in Canada, it seems like every doctor’s office has a notice saying they don’t prescribe narcotics.

Huh? And if the patient is obviously in a lot of pain, you’re just going to let them suffer? We’re in a period of hysteria over narcotics.

That said, it’s also important to note that, yes, you tend to perpetuate the behaviour that you reward.

This is why money should largely be kept out of doctors’ decisions about appropriate care (and everyone else’s). It should not be a consideration except in the most extreme cases. A doctor with no skin in the game, monetarily, will tend to make better patient care decisions, because patient care will be their primary concern.

And, oddly, not only is that good for patients, in most cases that don’t involve end of life care, it is also cheaper, though that’s not why you do it.

Money doesn’t belong in large number of places. It should not be a concern for frontline care workers in almost all cases.

Exhibit five million somethingty.

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