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Doctors Should Be Paid by Salary, Not Fee-for-Service, Argue Behavioral Economists

In an intriguing commentary on the way physicians are paid, the Journal of the American Medical Association argues that traditional fee-for-service payments create incentives for doctors to look at how much money they can make on multiple services, as opposed to what’s best for a patient. As reported by Carnegie Mellon University, paying a salary instead could cut back on over-provision of tests and over treatment of patients.

In plain language, fee-for-services encourages conflicts of interest, although usually articles like this are written in the context of pharmaceutical companies that might be shuffling incentives to your doctor to prescribe you their drugs. In this case, however, critics are talking about doctors’ interests in the services they prescribe. But, whether it’s drugs or tests doctors recommend, making it mandatory to declare conflicts of interest just don’t work that well.

This is because, despite cozy relationships with drug and device companies, many physicians believe they’re immune to the effects of free food, free travel and speaking gigs that essentially amount to free money. And this money doesn’t necessarily reflect better care for you on any level: Even the Centers for Disease Control and Prevention has been corrupted by conflicts of interest.

This is why you have to be your own advocate. Whatever your health problem might be, I strongly recommend digging below the surface using all the resources available to you to determine what medical treatment or advice will be best for you. Ask questions. Seek a second opinion. And change the game by taking control of your health through diet, exercise and other lifestyle factors.
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