How getting the right GP turns out to be a matter of life and death

If you manage to get an NHS appointment these days you probably feel a bit smug. My wife had one yesterday, although any reassurance about the NHS’s health from the existence of the appointment was slightly undermined by it taking place in a Portakabin behind a Screwfix car park.

We shouldn’t be too swift to crow if we get a GP appointment anyway, because it matters who it’s with. So concludes impressive Norwegian research into doctor quality, which, it turns out, varies a lot. In Norway, if you need to change doctor – because they retire, for example – the government allocates you a new one. A bit illiberal, but the randomness is helpful for researchers, allowing them to use different patient outcomes to measure quality.

Focusing on patients aged 55 and over, they found big gaps in quality, as measured by… death rates. A one standard deviation (that’s the typical gap between a doctor’s quality and the average) increase in GP quality is associated with a 12 percentage point decline in risk of death over two years.

The vast majority of the gap is about unobservable differences between doctors – think innate talent rather than practitioner model. And no, better doctors aren’t simply spraying their patients with more treatments. In fact, the Treasury should pay attention because the Norwegians’ per patient spend is lower. Instead, good doctors do a better job of diagnosing treatable illnesses earlier and more accurately.

One last thing before you rush off to pick a new GP: the research shows patients’ ratings of GPs are uncorrelated with GP quality. So those five-star reviews on Google? They count for diddly squat when it comes to keeping you alive.

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