ABSTRACT
The introduction in October 1995 of reference-based pricing as a cost-saving measure for British Columbia's drug benefit program represented an opportunity for collaboration between frontline practitioners and the bureaucracy that supports some of their work. If well-established principles of continuing education, quality improvement and modern management had been followed, practitioners in the field could have focused their individual and collective talents effectively and constructively on the task of improving cost-effectiveness in drug prescribing. Although the reference-based pricing program may well achieve its purpose of saving money, it is sad that it was not used to build bridges of common interest and mutual trust between two camps that are often in conflict.
Subject(s)
Drug Costs , Drug Prescriptions/economics , National Health Programs/economics , Reimbursement Mechanisms/economics , British Columbia , Cost Savings , Cost-Benefit Analysis , Humans , Reference Standards , Therapeutic EquivalencyABSTRACT
Seemingly intractable problems of overpopulation, ecologic degradation, diminishing resources and regional warfare are having a profound effect on global population health. Canadian physicians can assist in ameliorating these problems by helping to modify the overconsumption of natural resources at home and by participating in international health projects focused at the community level, where the health of individuals and that of their environment intersect. The author describes the work of the Canadian Hunger Foundation in Vietnam and Sri Lanka, where a team of professionals worked with local farmers to improve the local water supply, decrease soil erosion and increase food production. The team observed changes in the physical health of communities that resulted in part from interventions that empowered them to address their own problems.
Subject(s)
Ecosystem , Global Health , International Cooperation , Physician's Role , Canada , Humans , Social ResponsibilitySubject(s)
Conflict of Interest , Drug Industry/standards , Ethics, Medical , Physicians/standards , Canada , Humans , PamphletsABSTRACT
We are witness to a major change in the direction and focus of medical education and practice. After a period of fascination with increasingly specialized and technologically driven medical practice, we are moving to a more balanced view in which generalists are likely to play a greater role. We must recognize the trends in society that parallel this view and respond to the changing expectations of our patients. Training systems must reflect our understanding of this new era.
