Increase Doctor's fees and save money!

Another effort to improve the quality of care in the US, a pilot program in Philadelphia, pays a doctor's practice incentives to spend more time with their patients and monitor the patient better by paying them to increase staffing and encouraging them to use email and phone based monitoring so that patients are cared for on a more continuous basis.

The Indian version of this type of system would be interesting. Most GPs earn between Rs. 30 - Rs. 100 per office consultation with a patient and Rs. 200 - Rs. 300 for a home visit. For a doctor to take home Rs. 10,000 per month as income (before tax) she would have to see, on average 8 patients a day @ Rs. 50 per patient consultation and working 26 days in a month. To earn Rs. 25,000 (median income of a GP in India), the doctor has to see 20 patients a day. The doctor typically practices from 10am - 1pm and from 6pm - 9pm, 7 hours. Of the 7 hours, one can count approx. 5.5 productive hours or 330 minutes per day of consultation time. Therefore with 20 patients, the doctor spends about 16.5 minutes per patient.

The doctor has to understand the patient's medical history, hear about the most current symptoms, offer advice and/or prescribe medication or diagnostics, physically examine the patient all in 16.5 minutes. Clearly this is a challenge.

Given that Doctors, like everyone else, would want to earn more, they would end up seeing more than 20 patients a day, as a result 16.5 minutes reduces further. Clearly a sub-optimal situation from the point-of-view of the patient.

So incentives to increase the amount of time given to a patient should have a positive impact on the care received by the patient, even in India, don't you think?