Originally posted at:  http://onyeije.posterous.com/

One of the many problems faced by the healthcare delivery system is the way in which doctors are reimbursed for their work and the relationship of this reimbursement to clinical outcomes.  In a fascinating article in the New Yorker, Atul Gawande writes about the spectrum of physician practice patterns and reimbursement.

Dr. Gawande writes that in order to bring spending for medicine under control it will be necessary to encourage efficiency in spending.  Essentially, how can we get great outcomes while spending less; rather than spending a great deal to get little or no benefit.

Dr. Gawande compares the expenditures iin McAllen Texas to those in El Paso and the Mayo Clinic.

Highlights from the article:

• McAllen – Extremely high medical costs.
• El Paso and Mayo – Much lower medical costs.
• Outcomes: McAllen patients  DO NOT have appreciably better medical outcomes in comparison to those in El Paso or the Mayo Clinic.
• Reason for Discrepancy: McAllen doctors have an incentive to “do more” and treat patients as revenue streams

Another interesting perspective on this problem of Quantity vs. Quality was provided by Jay Parkinson in a recent edition of Fast Company.

Both articles are required reading for those interested in healthcare reform.