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There’s an interesting discussion at Overcoming Bias about a study that finds no significant different between outcomes (under specific circumstances) of patients treated by more expensive doctors and those treated by less expensive nurse practitioners.

In the case of practically any other human endeavor, a throng of enterprising individuals would jump in to try to take advantage of this discrepancy. If the pattern found in the study holds, the difference would likely be arbitraged away. While the effect could be as simple as a gradual adjustment of the salaries of both kinds of health care professionals, a more likely outcome would be a shift to a more efficient pattern of interactions among doctors, NPs, and patients. The transition to a more efficient division of labor is often disruptive and painful, but in the end we’re all better off.

There is, of course, some progress here. Walk-in clinics are becoming more common, and those responsible for launching them clearly see the gap:

[MinuteClinic CEO] Howe, [Revolution Health Group founder and former AOL chairman Stephen] Case and others stress that the clinics aren’t intended to replace but to complement doctor’s offices; they don’t treat chronic ailments or serious health problems. Still, there’s little question that they’re siphoning away some business by offering lower prices, shorter wait times and longer opening hours.

From the other direction, the number of Americans with health savings accounts is projected to grow to something like 6 or 8 million by 2008. This should fuel a lot of consumer-directed health spending, outside of the structure of traditional insurance, encouraging more providers to try new ways to get in front of that demand.

Will this actually lead to better health care? Time will tell. A rigorous study like the one comparing outcomes from doctors and nurse practitioners can shed light on opportunities and anomalies, but the knowledge-aggregating power of the market can eventually give us a more definitive answer.

(H/T to The Stalwart.)

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