UK Health Care Talk - Dr. Charlton

Dr. Rodger Charlton led a discussion on the UK medical system with focus on the differences in their primary care system. Dr. Charlton is a general practitioner in a small town in central England and the Director of Undergraduate GP Education and Associate Clinical Professor at Warwick Medical School. He was visiting Boston to share his experiences and research in primary care, and end-of-life and palliative care.

The health care system is called the National Health Service (NHS). It is funded by income tax and is provided to all residents of England regardless of ability to pay OR employment. Dr. Charlton shared about his own practice which includes comprehensive care with nursing staff, staff coordinator, triage receptionist, etc. He also shared that he sees significantly more patients a day than the typical US doctor and continues to make home visits on a regular basis.

Primary care doctors in England are reimbursed by the NHS based on the number of patients they have, not the number of procedures and services they provide. They are paid directly by the NHS; this process significantly reduces amounts of paper shuffling. A few years ago, the NHS changed reimbursement policies so that now primary care doctors make MORE money than specialists. This has increased the number of medical students who are entering into primary care significantly.

Does the US need a similar model of reimbursement? The UK has a system where 50% of its doctors are primary care doctors, a much larger proportion than the US. Would working towards changing this proportion in the US improve health outcomes?