Question

1. You are a policy maker in a province that is considering changing the way it pays physicians. Most of the physicians in this province are currently on a fee-for-service system. You have been asked to look at alternative modes of physician payment and the experience of these modes in other jurisdictions (i.e., other provinces and countries). Compare and contrast these modes, and indicate whether a mode other than fee-for-service might be more suitable for your province. Will it be suitable for all kinds of physicians? Will a mixture of methods be preferable?

Answer 1

There are mainly three modes of payments to physicians. It includes fee-for-service, capitation and salary. Each of these cash payment modes has negatives and positives. Therefore it is preferable to use the combination of these payments modes to reduce the negatives. The fee-for-service system is the predetermined fee of a physician for the services they provide. Capitation is the agreement between a medical insurance company and the physician according to the registration of patients or per capita to determine the payments monthly. Salary payment is a fixed amount of income without considering the number of patients or health care activities.

A most effective way to determine the remuneration of the physicians is to combine the positives from all these cash payments modes and pay according to their work. In my province, it better to choose the mixture of these modes in order to make a legitimate remuneration system. Hospitals are of different types; some are heavily crowded with patients and services where physicians have to work continuosly under pressure while some are not crowded at all. Therefore it is always preferable to determine the mode of payments according to the condition of provinces and organizations.