BMJ  2007;334:234 (3 February), doi:10.1136/bmj.39066.452847.68

Feature

Head to head

Is doctors' self interest undermining the National Health Service

Alan Maynard, professor of health economics

1 York University, York, YO10 5DD

akm3@york.ac.uk

Recent newspaper headlines have suggested that doctors' pay is responsible for the financial crisis in the NHS. Alan Maynard argues that financial and other self interest is endangering the service, but Laurence Buckman believes the renumeration is justified

The first 150 words of the full text of this article appear below.

Self interest is an integral part of every human's programming. The challenge is not to eradicate what is impossible to remove but how to channel these powerful forces to serve the individual and the public good. Economists regard self interest as the engine of economic development. As epitomised in the writing of the economics Nobel laureate Milton Friedman,1 the challenge for society is how to use self interest as an engine not only for economic development but as the means to maximise individual freedom in decentralised, competitive markets.

For Friedman and his 18th century predecessor Adam Smith,2 the "invisible hand" of self interest and the individual pursuit of improvement in a free market with minimal government regulation would ensure that society's scarce resources were used efficiently and economic growth maximised. This, in theory, makes self interest good.

This simplistic view ignores the realities of most markets, and the healthcare market . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Articles

Payment for performance in health care
Russell Mannion and Huw T O Davies
BMJ 2008 336: 306-308. [Extract] [Full Text] [PDF]

Is doctors' self interest undermining the National Health Service?
Laurence Buckman
BMJ 2007 334: 235. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Bovier, P. A., Arigoni, F., Schneider, M., Gallacchi, M. B. (2009). Relationships between work satisfaction, emotional exhaustion and mental health among Swiss primary care physicians. Eur J Public Health 0: ckp056v1-ckp056 [Abstract] [Full text]  
  • Mannion, R., Davies, H. T O (2008). Payment for performance in health care. BMJ 336: 306-308 [Full text]  

Rapid Responses:

Read all Rapid Responses

GPs are getting too much, for too little
Alan Luckhurst
bmj.com, 2 Feb 2007 [Full text]
More work = more pay
Hendrik J Beerstecher
bmj.com, 5 Feb 2007 [Full text]
A view from the ivory tower
Gavin Bullock
bmj.com, 6 Feb 2007 [Full text]
Doctors' and patients' self-interest.
Ian Quigley
bmj.com, 5 Feb 2007 [Full text]
Science, Pseudoscience and Efficiency
Richard Rosin
bmj.com, 5 Feb 2007 [Full text]
The self-interested argument.
Adrian G Sutton
bmj.com, 7 Feb 2007 [Full text]
Jeopardising trust
Anne Savage
bmj.com, 27 Feb 2007 [Full text]



Access jobs at BMJ Careers
Whats new online at Student 

BMJ