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British Medical Journal To Report Widespread Discrimination Against Indian Doctors In Uk

U.S. physician payments vary widely, mysteriously: study

Researchers have found that white doctors in the UK are almost three times more likely to land a hospital job than ethnic minority doctors (13.8% versus 4.8%) with the study to be published by the British Medical Journal ( BMJ) raising serious concerns over discrimination in the UK general practitioner examination. The data provided by the Royal College of General Practitioners (RCGP) and the General Medical Council (GMC) found Indian medical candidates who trained outside the UK were also more likely to fail the clinical skills assessment than their white UK colleagues (65% versus 4.5%). The figures, based on 2012 ethnicity data from 50 hospital trusts in England, show black or black British applicants were the ethnic group least likely to secure hospital doctor jobs (2.7% success rate), followed by doctors of mixed ethnicity (3.5%) and Asian and Asian British doctors (5.7%). Interestingly, doctors who didn’t disclose their ethnicity during the application process had the highest success rate in landing jobs of any ethnic group (23%) – further muddying the waters around potential discrimination in the appointment of National Health Service (NHS) doctors. The study therefore says it cannot rule out “subjective bias owing to racial discrimination” in the exam. In order to practise as an accredited general practitioner (family physician) in the UK, doctors must pass the MRCGP (Membership of the Royal College of General Practitioners) examination. A judicial review into the fairness of the controversial clinical skills assessment (CSA) test – the examination which confirms that a doctor has satisfactorily completed specialty training for general practice and is competent to enter independent practice – will be heard at the Royal Courts of Justice next month. The courts have listed the review launched by the British Association of Physicians of Indian Origin (BAPIO) for October 18. Indian doctors working in the UK has taken the RCGP and the GMC to court alleging the examination is flawed and discriminates against international trainees. FEATURED ARTICLES


Physicians at the high end of the reimbursement spectrum get more than twice as much as those at the low end for the same service, with little apparent reason for the difference, researchers say. “We figured that if we looked at fairly similar office services across clinics, the amount received by doctors might not vary much,” said Laurence Baker, co-author of the study and chief of health services research at Stanford University in California. “But that was not true.” In the push to contain healthcare costs, focusing on how much care patients use won’t solve the problem unless the market forces determining what doctors charge and what insurers pay are better understood, Baker and his colleagues write in the journal Health Affairs. Unlike other health care cost studies, theirs looks at actual reimbursement amounts to physicians, and not the amount billed. The researchers analyzed more than 40 million claims filed in 2007 for nearly a dozen types of service ranging from five-minute check-ups to comprehensive exams. The most common claim filed was for a “problem-focused” exam lasting about 15 minutes with a patient the physician already knew. The lowest-paid 5 percent of doctors received $47 or less for the visit while the highest-paid 5 percent received $86 or more. The average reimbursement amount was $63. For more complex, yet identical, office visits lasting longer and involving a new patient, the reimbursements ranged from $103 or less to $257 or more. The study comes as state and federal government agencies are gearing up for national health insurance enrollment under the Affordable Care Act, beginning October 1. The price differences couldn’t be explained by the patients’ age or sex, the physicians’ specialty, the patients’ insurance plan type – preferred provider organizations (PPO) or point of service (POS) – or whether the physician was in the plan’s network. Geographic location accounted for some of the price variation, but only about one-third of it. Even with location taken into account, researchers could not pinpoint differences among specific cities because Truven Health Analytics, the company that provided the data, did not allow precise location information to be published in the study. “The point is that (there is) very little that can explain these price differences, no matter what information you put into the model,” Dr. Renee Hsia, professor of emergency medicine at the University of California at San Francisco, told Reuters Health.

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This entry was posted on September 29, 2013 by .
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