Paying Doctors to Diagnose More Depression is Unethical

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It is “unethical” for the British government to establish expected rates of depression and to pay doctors per diagnosis to increase the diagnosing of depression, writes a UK physician in the British Medical Journal.

OnMedica reports that, “Recent updates to NHS England’s General Practice Outcome Standards and the Primary Care Web Tool include practice-level data on 29 separate indicators across seven clinical areas, and each practice in England has a set diagnosis rate for each of the seven conditions – diabetes, atrial fibrillation, coronary heart disease, asthma, chronic obstructive pulmonary disease, dementia, and depression – with the intention of exerting pressure on GPs to ‘improve’ diagnosis rates.”

“Last month, there was public outcry at the news that GPs in England would be paid £55 for each case of dementia diagnosed,” states a press release about the commentary in the BMJ. “Now come targets for six other conditions… But the data on which they are based are flawed, and the approach incentivises potentially harmful overdiagnosis.”

Diagnosis targets in primary care are misleading, unethical, UK experts say (BMJ-British Medical Journal press release on ScienceDaily, December 3, 2014)

Diagnosis targets unethical says GP (OnMedica, December 3, 2014)

(Subscription required) Target diagnosis rates in primary care are misleading and unethical (Brunet, Martin. British Medical Journal. December 2, 2014 DOI: http://dx.doi.org/10.1136/bmj.g7235)

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5 COMMENTS

  1. More than 10% percent of English adults are already on antidepressants, so how much ‘medical depression’ would the regulator like to see?

    GPs generally prescribe, and in England prescriptions are publicly funded. This money will go to producers who will then be in a position to further promote their dubious product and to reward their helpers.

  2. B
    GPs in the UK get about £100 per patient per year, and the dementia promotion payment works out at £55. A British GP might earn £100,000 plus per year, and my former GP advertises at £175 per private consultation.

    I dont see how £55 would pay for the comprehensive information gathering and testing necessary for something as serious (and worrying) as a diagnosis of dementia.

    I think this is more likely a drug pushing initiative.