There are two schools of thought about what's wrong with modern medicine:

1. The doctors are at fault.
2. The payment system is at fault.

Strangely, the first camp includes almost all researchers (read: other doctors) who write for medical journals as well as almost everyone in the health policy community. On this view, doctors (unlike lawyers, accountants, engineers, architects, etc.) are creatures of habit, stuck in their own (imperfect) ways of doing things. The public policy problem: how to get doctors to adopt the best practices, learn to use computers, work in teams, adopt safety protocols, etc. in the face of psychological resistance.

The opposing camp consists of yours truly and a handful of others. Our view is that doctors are just like other professionals. They respond to economic incentives. The policy problem: how to change the incentives in the perverse way doctors are paid.

So who is right?

Continue Reading at the John Goodman Health Blog