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Having too many doctors translates
to higher costs, not improved care. A February article in the journal
Health Affairs based on recent Dartmouth University research suggests
that areas with an abundance of physicians show higher healthcare costs
per person than areas with fewer doctors, but no increase in health benefits.
In Miami, where the doctor
population is particularly high, Medicare pays over 50% more per person
than in Minneapolis - with no difference in the quality of care to residents
of either city. And a 65-year old in Miami spends $50,000 more in his
lifetime on medical care, and visits medical specialists six times more
often in the final six months of life, than his counterpart in Minneapolis
- with no difference in life expectancy for either. Regional differences
in medical costs are not to blame, according to the article. Instead,
where the supply is greater, the demand for their services is greater;
that is, more doctors means more visits to each of those doctors, without
any benefits to health for those excess visits, just higher costs.
The researchers also studied
high-risk newborns and saw the same trends: in areas with high concentrations
of neonatologists and intensive care beds, infants spent considerably
more time in the care of those physicians and in those beds. But, except
compared to areas in the lowest 20% in terms of supply of such specialists,
there was no difference in mortality rates.
Perhaps without the doctor's
awareness, the greater the density of doctors in a region, the more time
each doctor spends with their patients. And the more money the patients,
and our government, spend on those doctors - without any increased benefit
to health.
New
York Times July 21, 2002
Health
Affairs March 2002 (long PDF download)
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