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Letters

The authors respond to “Fueling the culture of distrust in doctors”

Daniel J. Dutton, Pierre-G. Forest, Ronald D. Kneebone and Jennifer D. Zwicker
CMAJ July 23, 2018 190 (29) E891; DOI: https://doi.org/10.1503/cmaj.69414
Daniel J. Dutton
Postdoctoral scholar, School of Public Policy, University of Calgary, Calgary, Alta.
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Pierre-G. Forest
Director, School of Public Policy, University of Calgary, Calgary, Alta.
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Ronald D. Kneebone
Professor, School of Public Policy, University of Calgary, Calgary, Alta.
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Jennifer D. Zwicker
Assistant professor, School of Public Policy, University of Calgary, Calgary, Alta.
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The authors respond to a letter from Dr. Nadia Alam.1

In discussing the findings of our study on the effect of provincial spending on social services and health care on outcomes in Canada, we chose the physician remuneration example because it is a classic funding issue in Canadian health care.2 In the past, negotiators have strategically used the media to apply pressure or sway public opinion, making this an example to which CMAJ readers could relate. Another example is the recent open letter from Quebec physicians in which they protested a pay increase.3

Examples are helpful as they underline the difficult choices that must be made before money can be reallocated between health and social portfolios. Controlling growth and reducing total expenses are two different things; we are not suggesting that we remove well-established health care services like vaccination or that physician salaries should be the one and only source for potential reallocation of tax dollars from health budgets to social services budgets. Instead, what is needed is a thoughtful comparison of the health benefits to the population that are attributable to spending on provincially funded health care relative to the benefits generated by spending on affordable housing, social assistance and programs designed to address food insecurity.

Footnotes

  • Competing interests: None declared.

References

  1. ↵
    1. Alam N
    . Fueling the culture of distrust in doctors [letter]. CMAJ 2018;190:E370.
    OpenUrlFREE Full Text
  2. ↵
    1. Dutton DJ,
    2. Forest P-G,
    3. Kneebone RD,
    4. et al
    . Effect of provincial spending on social services and health care on health outcomes in Canada: an observational longitudinal study. CMAJ 2018; 190:E66–71.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    The Canadian Press. More than 200 doctors ask Quebec to backtrack on proposed pay increases. Globe and Mail [Toronto]. Available: www.theglobeandmail.com/news/national/more-than-200-doctors-ask-quebec-to-backtrack-on-proposed-pay-increases/article38111920/ (accessed 2018 June 22).
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Canadian Medical Association Journal: 190 (29)
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Vol. 190, Issue 29
23 Jul 2018
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The authors respond to “Fueling the culture of distrust in doctors”
Daniel J. Dutton, Pierre-G. Forest, Ronald D. Kneebone, Jennifer D. Zwicker
CMAJ Jul 2018, 190 (29) E891; DOI: 10.1503/cmaj.69414

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The authors respond to “Fueling the culture of distrust in doctors”
Daniel J. Dutton, Pierre-G. Forest, Ronald D. Kneebone, Jennifer D. Zwicker
CMAJ Jul 2018, 190 (29) E891; DOI: 10.1503/cmaj.69414
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