What were incentive payments accomplishing?

I read with interest the analysis of incentive payments to family physicians in British Columbia for treating patients with chronic disease.1

The study’s finding of no health care outcome changes supports my own observations: those of us who have chosen family practice as a career want to do a good job, regardless of whether there is an incentive payment attached.

It was no surprise that measures of patient outcomes have not changed. I believe that there was another valid reason for initiating incentive payments — to support full-service family practice as a whole. The main change I have witnessed has been in the career choices made by new graduates since the incentive programs have been fully operational. In the decade before the incentive fees, our communities had no trouble finding physicians to staff walk-in shifts, and many new graduates were deciding to do hospitalist work because they viewed financial disincentives to entering full-service family practice. Family physicians who loved their practice were choosing to take half days off to work in a walk-in clinic just to be financially competitive with their colleagues.

I have watched a gradual shift this decade whereby physicians are back in their offices, and new grads are coming to communities to set up a full practice. I believe this is a direct result of BC incentive payments allowing doctors to choose to practise long-term comprehensive medicine on a financially equitable playing field.