Health services utilization and physician income trends.

Statistics from several Organization for Economic Cooperation and Development countries on consumption and cost of health care services, physician workload, and physician earnings are presented. Data are analyzed according to type of physician payment used: fee for service, per case, capitation, or salary. Incentives theoretically embodied in each payment method are often offset by other factors--scale of charges, patient out-of-pocket payment, and patient access or physician activity restrictions. Moreover, the impact of payment method on use appears to be weaker than the impact of such factors as population morbidity, national health insurance, professional ethics, and medical technology.