Meadbh
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Jul 22, 2006
- Messages
- 11,401
I think it would be most interesting to hear a perspective from a doctor who after working for a system like Britain's NHS or Canada's to then be offered a position in the US with our fee structure. I wonder if the higher income would offset the added headache of paperwork, and dealing with countless insurance policies, and malpractice. In the end. I wonder which system a doctor would chose, having an adequate dose of both.
I did some of my training in the US (late 80s) so I have some familiarity with the system. I do remember that our small academic department had six full time staffers whose job it was to bill. As a trainee, I had a salary, so I didn't have to worry about chasing bills, and the same could be said for my bosses. It would be a different story in private practice.
I spent all of my attending physician career in Canada. Most of that time was spent in a province where my colleagues and I were paid on a sessional basis for most of our work. We worked in ICU on a weekly schedule, and bills were submitted to the Provincial Department of Health on our behalf. We got paid the same whether it was a busy or a quiet week, because it all evened out in the end. Our physicians' organization negotiated with the Province and we got raises from time to time, often linked to productivity. It worked very, very smoothly and I never had to worry about paperwork. However, I also spent a couple of years working in another Province where the model of care was private practice. This was more onerous with respect to billing, rejected claims, etc. It was, in fact, a PITA. So I think that you have to look at the model of care, not just the country.