In which she boggles

[zeborah]

I already knew that the USan health system was crazy and ridiculously expensive. (There are USans who come to New Zealand for surgery because even with the airfares it's cheaper plus you get to visit New Zealand which, as previously reported in this LiveJournal, is the coolest country in the world.) But then I was reading this article and it starts talking about how, compared to other systems, the Mayo Clinic is cost-efficient because:

"[...] decades ago Mayo recognized that the first thing it needed to do was eliminate the financial barriers. It pooled all the money the doctors and the hospital system received and began paying everyone a salary, so that the doctors' goal in patient care couldn’t be increasing their income."

And I'm going <boggle> with extra bold font! And moreover, WHUT?

Do you mean that doctors elsewhere in the US don't receive a salary? That they instead receive a portion of each of their patients' fees? Seriously?

(For a private practice, sure, because that's what a private practice is. But I mean in hospitals and larger practices and stuff.)

Isn't that like paying judges according to the fines they levy?

It's been a while since I boggled this much. I don't get it. I must be misinterpreting something. Because if that's the system... Seriously. How could you trust your doctor's recommendations? Who could ever think that was a good idea?

OUT OF BOGGLE ERROR

PLEASE EXTEND BOGGLOMETER TO CONTINUE BOGGLING

Comments

[tauira.livejournal.com]

OT but Mayo Clinic never fails to make me imagine using salad dressing as some kind of salve.

[zeborah]

We should develop this for the pharmaceutical market and patent it and sell it for a hundred dollars a tube and then we shall become rich, rich!

[jhetley.livejournal.com]

When I had surgery a few years back, we got separate bills from the hospital, the surgeon, the anesthesiologist, the EKG clinic for pre-op screening . . .

Health care is the largest industry in our city.

[joycemocha.livejournal.com]

As far as I know, Kaiser and some clinics are the only ones with salaried doctors. Otherwise, they get paid out of fees.

[slrose.livejournal.com]

Most doctors are just associated with hospitals, not on staff. There are doctors who get a salary (my cousin, who's a pathologist, for example,) but most of them are really in private practice.

[heleninwales.livejournal.com]

How could you trust your doctor's recommendations?

When I was having Women's Problems, which was over 10 years ago now, I (naturally) turned to the Internet for advice. I found there was big feminist outcry against the overuse of hysterectomy. Many gynaecologists, apparently, looked on the female reproductive tract as a kind of optional extra that women really didn't need, so they could make $$$$s by performing hysterectomies that couldn't really be justified on medical grounds.

Initially I was won over by the feminists' statistics showing how many unnecessary ops were performed and fell in with their anti-hysterectomy thinking -- until I finally realised that these women were American and that in the US system, the more treatment doctors can give a patient, the more money they can make.

So if an American gynaecologist said you ought to have a hysterectomy, you needed to consider the advice very very carefully because they would make a profit on the op. But it finally dawned on me that when the specialist in the cash-strapped NHS specialist said I needed a hysterectomy and that it was urgent, I needed a hysterectomy. It was not in their interests to perform surgery unnecessarily because it was a cost.

[Edited for clarity.]

[phaetonschariot.livejournal.com]

..........wtf.

[sciamanna.livejournal.com]

I boggled about the same thing when I found out myself, about a couple of weeks ago and in much the same context...