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January 12, 2011


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Robert Watkins

I don't know any doctor who went into family medicine expecting convenient working hours. I don't know any doctor who doesn't dream of having more time to spend with his or her patients. So I have to strongly disagree with your assertion that, if we pay family physicians better, the only change we'll see in their behaviour is that they'll go home earlier.

Jean Antonucci

No no -This is a wonderful post. I don't have time for this blog stuff , very much.But while it ticks me off to work for free, paying docs more ,by itslef, only lets themgo home earlier.
Getting them to change their ways takes something else and Gordon gets at it a bit here. What makes change is a resaon to do it + a reach out and touch individually approach . it is like the old joke about how many psychiatrists it takes to change a ligthbulb-- only one but the light bulb has to want to change.And it is like what it takes to work with kids. It's one on one.
And then, then you have to make change possble/accessible the one on one agian. The elements the IMP project worked for alot of people becasue they told their story and got heard and were given tools.That is slow work. thoug, if we had started a long time ago we'd be further down the road. Impersonal mass initiaves don;t work well.

Robert Watkins

All excellent points, but I don't think it has to be this complicated.

Family physicians are infinitely flexible and open to change: they have to be to survive in today's hostile environment. If we want different results, ALL we have to do is pay for them, and the doctors will create the necessary support systems on their own. Right now, we pay for MRIs, cardiac stents, and epidural steroid injections, and doctors figured out by themselves how to maximum their use.

Maybe the title of the post is a little misleading. How about "Why is it so hard to get health care reformers to understand that primary care physicians refuse to do any more work for free"?


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