@chippydoo That sounds like a very good plan. It's disgusting that the private doctor forces you into a visit to see your results. It's similar to how they make you come into the $$$ doctor's office there just for a monthly Firmagon injection (since I was in a wheelchair when I was on it, we did ours at home after a Public Health nurse trained my spouse; most people here go to an Infusion Centre. )

My reply was specifically about overtreatment. If someone wanted to determine how much overtreatment happens in the U.S. for the sake of profit, they'd have have to compare with patient treatment in other rich countries where institutions and doctors don't benefit financially (or at least, not significantly) by offering more treatment.

I don't think prostate cancer treatment in the U.S. is too different from other countries, for example, except that you do use expensive, premium procedures like PSMA-PET and proton-beam radiation a lot without any proven increased survival benefit (at least, not yet). There's also a joke that in the U.S. they'll give you an MRI for a sprained wrist, because there are too many MRI machines and they lose money if they're sitting idle. 🙂

Purely as an hypothesis, I suspect the biggest difference will be from the fact that big medical machines and their support facilities are capital investments in the U.S. and have to turn a profit or at least pay their way (even in non-profit hospitals), while in Canada, with a very few private exceptions, they're more like public highways or parks: they're there if you need them, but there's no financial incentive to push people into them.

@chippydoo it is unfair to assume your doctor requires you to visit to get your test results for his personal financial gain. Most of the care that physicians provide is done behind the scenes and not during face to face contact, all of which is time consuming, not to
mention the cognitive skills involved in monitoring patients and working to achieve the best possible outcome. Do you know of any professional who provides services free of charge or do you prefer a physician who is burnt out and under compensated to be providing your care? Most doctors spend an hour behind the scenes for every hour they spend in direct patient care. Many work 12-14 hour days when that extra time is factored in. Furthermore, the face to face encounter provides continuity of care and an opportunity for the provider to make adjustments to a treatment regiment based on observations that can only be encountered in an appointment setting.

If a person is uncomfortable with his/her doctor, then by all means find another provider. But don’t ascribe greed or a lack of compassion to a physician out of that frustration.

Even those countries with national healthcare coverage are not immune to patient frustration, and many who can afford it, have private insurance to allow them to seek care outside of the NHS, so that is not always a panacea.

And lastly, I am one of the first and loudest to encourage patients to seek care at an academic center, but because I believe that is where the best and most up to date treatment protocols are employed and not because the physicians are compensated any differently than those in private practice.