Intended for healthcare professionals

Rapid response to:

Reviews Book

MMR: Science and Fiction. Exploring the Vaccine Crisis; MMR and Autism: What Parents Need to Know

BMJ 2004; 329 doi: (Published 28 October 2004) Cite this as: BMJ 2004;329:1049

Rapid Response:

Making money from vaccines.

I was interested to read in the press today that the GP gaoled for
fraud had been able to earn £70,000.00 a month by giving single injections
rather than MMR. Short terms financial gains of this magnitude are not in
anyone's interest except the GP.

In an earlier eLetter I raised the possibility of staggering
reimbursemnts for operations performed delaying some 50% to further
increments 2, 5 and even 10 years later. How might this system of
reimbursement be successfully applied to physicians and GPs? By rewarding
GPs for reducing the number of times a patient seeks retreatment for any
given condition such as back pan? By adjusting their reimbusements for
detecting cancers for the stage at which the disease is detected? By
rewarding them for detecting vascular diseases before aneurysms are
excessively large and/or before organ dysfunction or damage occurs? What
of vaccines? By rewarding GPs for preventing diseases and deferring
reimbursements for 5, 10 or even 15 years. Deferred reimbursements might
be especially successful in preventing obesity and its sequelae and in
achieving and maintaining weight reducion in the morbidly obese. In
raising the potential for profits from innovations loans could be obtained
and outside investors even attracted without any risk of unacceptable
conflicts of interest.

The beauty about this proposal is that it would not only address
governmental and patient needs it would also address the costs of failed
treatments and GP/physician pensions. In such a system savings would be
effectivly enforced and a GP or physician might even be able to afford
to retire long before a surgeon with a busy private practice. Most
importantly effort and clinical excellence would be rewarded. The system
would not, however, work unless patients had private insurance. The
gaoled GP is highly unlikely to have committed fraud in such a system.

Competing interests:
None declared

Competing interests: No competing interests

25 December 2004
Richard G Fiddian-Green
c/o Sanders, Temple Gdns, Moor Park.