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GPs and healthcare costs

8 October 2010
It may be common knowledge that doctors’ pay outstrips average wages, with the really high earnings going to medical specialists. But now, more and more doctors are becoming specialised, with implications for costs and healthcare policy more generally. There were some 3.2 million doctors in the OECD area in 2008, which is over 40% more than in 1990 in absolute terms. But looked at on a per head basis, the number of specialists expanded by about 50% over the same 18 year period,  compared with a mere 15% rise per capita for GPs.
data source (xls)
As a result, the number of medical specialists now exceeds generalists in all but four OECD countries–Australia, France, Korea and Portugal.  This trend towards specialisation may reflect advancements in medical technologies and the increasing complexity of healthcare.  But it also reflects a a widening pay gap.
Indeed, despite the sharp rise in the number of specialists, their pay has grown  faster than that of generalists in a diverse group of OECD countries, includingAustralia, Finland, Hungary and the Netherlands .  Only in a few European countries, such as Belgium and Luxembourg, has the income of generalists grown faster than that of specialists.
Having more specialists is clearly not bad in itself, but a shift away from GPs can undermine primary care and increase costs pressures.
The UK is one  country that has taken deliberate steps to improve the relative attractiveness of general practice .  New contracts were introduced in 2004, and since then GP pay has risen sharply. Whether the extra cost incurred in improving the GP contracts has delivered value for money is less clear. But the search for policies to encourage a more effective GP/specialist balance is set to continue.

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[this post was edited on the 12th of October]

7 Responses leave one →
  1. David G. Moores permalink
    October 16, 2010

    Once again OECD data helps to uncover what is realling going on. ‘Doctors of limited or restricted practice’, otherwise known as ‘specialists’ have long enjoyed top tier status despited their relatively limited impact on health outcomes for populations, their driving healthcare costs through the roof, and their significant appetite for consuming resources.
    Finding the ‘best impact’ ratio or balance between doctors of ‘limited or restricited practice’ and GPs/FPs(primary care) is a challenge. Unfortunatley, here in Canada, the Canadian Institute for Health Information (CIHI) still maintains we have a 50/50 ratio between ‘limited or restricted practitioner’ and generalists, a reality that has NOT existed for the past 20 years!! Medical specialism in Canada has become even more sub-specialized and continues in that direction, consuming even more and more of publically funded dollars, without the commensurate impact on health status and health outcomes.
    Cheers
    David

  2. David G. Moores permalink
    October 16, 2010

    Once again OECD data helps to uncover what is realling going on. ‘Doctors of limited or restricted practice’, otherwise known as ‘specialists’ have long enjoyed top tier status despited their relatively limited impact on health outcomes for populations, their driving healthcare costs through the roof, and their significant appetite for consuming resources.
    Finding the ‘best impact’ ratio or balance between doctors of ‘limited or restricited practice’ and GPs/FPs(primary care) is a challenge. Unfortunatley, here in Canada, the Canadian Institute for Health Information (CIHI) still maintains we have a 50/50 ratio between ‘limited or restricted practitioner’ and generalists, a reality that has NOT existed for the past 20 years!! Medical specialism in Canada has become even more sub-specialized and continues in that direction, consuming even more and more of publically funded dollars, without the commensurate impact on health status and health outcomes.
    Cheers
    David

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