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Why we must pay doctors for Digital Health

I’m following up my post from last week on the ‘Digital Health Divide’ with a practical suggestion on how we can achieve equality of access to healthcare for us digital natives. Quite simply, we have to pay doctors more. Before you turn away, let me explain how I’ve come to this conclusion.

This week’s headlines

This week I saw some news flow that really made me stop and think:

  • Firstly there was a new survey (and for a change the respondents were multi-country, not just the US) which said 80% of smartphone users would like to interact with their doctor via mobile. No surprises there, it simply confirms the pent-up demand I wrote about last week.
  • Secondly I read this item from BBC News which said that UK patients were finding it more difficult to see their GP. I think it’s safe to assume that the response to this increased demand won’t be a mass hiring of additional doctors, and the well-worn approach of importing doctors from other countries is not viable in the long-run (quite apart from the morality of depriving a poorer country of their scarce resources).

What’s the prescription?

Now, I’m no genius, but put the two items together and it seems obvious that the answer must be digital health – patients are saying they want it, and we surely can’t deal with the demand if we don’t do something different. But simply seeming logical, however over-whelming that logic is, does not mean it will happen – if it was so obvious it would already have happened wouldn’t it? So I started thinking about the possible reasons that doctors haven’t introduced digital health access of their own accord. There could be any number of reasons such as regulation, lack of evidence, lack of understanding but I think we all know that none of these stand up to examination. I think the real reason for resistance to change is largely based on compensation – ‘you want me to do things differently but you aren’t really incentivising that change’.

Looking back, I noticed that the BMA (the professional association for doctors in the UK) only tend to discuss introduction of new technology in the context of their overall remuneration contract (as reported here for example). I also recalled how a key part of health reform in the US was the introduction of incentives with the HiTech Act to encourage health IT adoption. These subsidies had a considerable effect, with electronic health records now up to 78% penetration (from 18% pre-stimulus).

Can we afford this?

Some of you may think that doctors are paid enough already, and some of you may feel that our budget crisis in healthcare is already so acute that we can’t afford a financial stimulus to get this ball rolling. But I’m not talking about large ongoing payments or even funding all of the new technology – this should be self-funding ultimately. I’d liken it to development aid – when you want a positive outcome it’s worth putting up a little bit to prime the pump. As a rough example, a fund equivalent to £5 per head of the UK population would generate a stimulus find of £320 million (or £7,441 per General Practitioner), quite a ‘nudge’.

What do you think? Would you contribute £5 to get your doctor on-board with digital health? Can we afford not to? Let me know your thoughts – or you can always contact me.

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