ArticleBMC health services research2024
Time is money: general practitioners' reflections on the fee-for-service system.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- General practitioners' type of remuneration and antibiotic prescriptions. An analysis of patient switches using nationwide registry data.Scandinavian journal of primary health care · 2026Article
- Variations in general practitioners' referrals to low-value MRI examinations in Norway: A nationwide register-based study.The European journal of general practice · 2026Article
- Supporting General Practitioners to Deprescribe Benzodiazepines and Z-Drugs in Primary Care: Findings From a Modified Delphi Study.Basic & clinical pharmacology & toxicology · 2026Article
- Upskilling in Healthy Longevity Medicine and Its Association With Physicians' Implementation Intent and Self-Reported Clinical Confidence: Cross-Sectional Observational Study.JMIR medical education · 2026Observational
- Can the remuneration scheme of general practitioners affect their antibiotic prescription behaviour?Health economics review · 2026Article
- Implementation of values-based healthcare in inflammatory bowel disease-a review.Journal of Crohn's & colitis · 2026Review
- Beyond the dental clinic: ending the global stagnation in pediatric caries with program science.Frontiers in public health · 2026Article
- Family physician pay inequality: a qualitative study exploring how physician responses to perceived patient expectations may explain gender, race, and immigration status pay differences.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Medical certification in sickness benefit schemes (I): theoretical perspectives and return-to-work.Annals of occupational and environmental medicine · 2025Review
- Primary care physicians' job satisfaction in eleven Western countries: a cross-sectional study.BMC primary care · 2025Article
- Healthcare Continuity in Crisis: Addressing Gaps in Longitudinal Care Through Inferential Statistics.Cureus · 2025Article
- Waiting lists in health care: multiple perspectives.Cadernos de saude publica · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundFee-for-service is a common payment model for remunerating general practitioners (GPs) in OECD countries. In Norway, GPs earn two-thirds of their income through fee-for-service, which is determined by the number of consultations and procedures they register as fees. In general, fee-for-service incentivises many and short consultations and is associated with high service provision. GPs act as gatekeepers for various treatments and interventions, such as addictive drugs, antibiotics, referrals, and sickness certification. This study aims to explore GPs' reflections on and perceptions of the fee-for-service system, with a specific focus on its potential impact on gatekeeping decisions.
methodsWe conducted six focus group interviews with 33 GPs in 2022 in Norway. We analysed the data using thematic analysis.
resultsWe identified three main themes related to GPs' reflections and perceptions of the fee-for-service system. First, the participants were aware of the profitability of different fees and described potential strategies to increase their income, such as having shorter consultations or performing routine procedures on all patients. Second, the participants acknowledged that the fees might influence GP behaviour. Two perspectives on the fees were present in the discussions: fees as incentives and fees as compensation. The participants reported that financial incentives were not directly decisive in gatekeeping decisions, but that rejecting requests required substantially more time compared to granting them. Consequently, time constraints may contribute to GPs' decisions to grant patient requests even when the requests are deemed unreasonable. Last, the participants reported challenges with remembering and interpreting fees, especially complex fees.
conclusionsGPs are aware of the profitability within the fee-for-service system, believe that fee-for-service may influence their decision-making, and face challenges with remembering and interpreting certain fees. Furthermore, the fee-for-service system can potentially affect GPs' gatekeeping decisions by incentivising shorter consultations, which may result in increased consultations with inadequate time to reject unnecessary treatments.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.