Author Affiliations: Institute for Health Policy Management and Evaluation (Dr Detsky), Department of Medicine (Drs Detsky and Verma), University of Toronto, Toronto, Ontario, Canada; and Department of Medicine, Mt Sinai Hospital and University Health Network, Toronto (Drs Detsky and Verma).
Health care expenditures are a major concern of governments in Canada and the United States. Over the past 40 years, a variety of approaches have been used to control costs, including global budgeting, managed competition, cost sharing, and pay for performance. Policy makers recognize that physicians play a central role, with some estimates suggesting that physicians control 80% of health expenditures.1
Detsky AS, Verma AA. A New Model for Medical EducationCelebrating Restraint. JAMA. 2012;308(13):1329-1330. doi:10.1001/2012.jama.11869