The Doctor Dilemma: Public Policy and the Changing Role of Physicians Under Ontario Medicare

John H. Gryfe is an oral and maxillofacial surgeon practising in
Toronto.

According to the author of this book, practitioners who are opposed to
government management of health care “tend to be traditionalists and
frequently isolated from the political and economic forces acting on the
environment in which they practise.” Over the last decade,
budget-conscious Queen’s Park planners have argued that inappropriate
physician-driven use of medical services—i.e., freewheeling, poorly
policed health-care delivery—must be reconfigured to produce a
fiscally responsible, user-friendly, and participant-satisfied system.
Thwarting most attempts at reform, however, is the fear among physicians
that any such process will challenge, and ultimately dilute, the
profession’s traditional autonomy.

The Harris government has targeted five representative areas for
reform: hospital utilization, quality assurance, outcome measurement,
need-based planning, and community-based planning and resource
deployment. This scholarly, thoroughly researched, and well-organized
book devotes a chapter to each of those areas. Shortt is director of the
Queen’s University Health Policy Research Unit and a professor in that
university’s Departments of Community Health and Epidemiology and
Family Medicine.