Intended for healthcare professionals

Bmj Usa: Editorial

Paying physicians to treat tobacco use disorder

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E68
  1. Marc Manley (, executive director
  1. Center for Tobacco Reduction and Health Improvement, Blue Cross and Blue Shield of Minnesota, St. Paul, Minnesota, USA

    It may take more

    This article originally appeared in BMJ USA

    In the United Kingdom, as in the United States, discussions of health care frequently focus on payments for physicians and the impact these payments might have on patient care. Although they reimburse for any number of treatments and preventive care visits, many public and private insurers do not pay physicians to treat patients for nicotine dependence.1 In this issue of BMJ USA (p 519), a study by Coleman and his colleagues2 suggests that the promise to pay British general practitioners £15 (about $22) per smoker who quits is not enough to change the way they treat patients who smoke. The promised payments were small and were based not on the provision of treatment, but on the hoped-for results of the service—smoking cessation and continued abstinence for at least three months. Detailed interviews with these physicians3 suggested that many of them had done the financial math and decided that the new payments were inadequate …

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