Physicians response to government control

As governments tried to control rising health care costs by micromanaging doctors, physicians made changes needed to maintain their incomes. As a small business, services provided had to be looked at as to cost, time, and remuneration. Most physicians continued to provide services that were not cost effective out of a sense of obligation to patients. Since there were still plenty of physicians in Canada and some competition for patients, some services were seen as a "lost leader". Many physicians hung on to the idea that the government simply "didn't understand the situation" and if they continued to try to "educate" the government, things would turn around.
By the late /70s and early /80s however, there was a realization on the part of primary care physicians that they would have to cut costs. One of the first services to disappear were house calls. The physician driving to a residence to see a patient was clearly a "waste" of time and a patient convenience. Further if a diagnostic mistake was to be made, it would more likely happen in the patient's home than the doctor's office with proper facilities. This was followed by physicians not assisting in ther patient's surgeries and by the late /80's more and more family doctors were giving up their hospital priveledges. Most of these services traditionally had not been cost effective, but with cost going up, the fee schedule basically controlled by the government, and a growing wedge between physicians and their patients, a process started that would reach its' peak in the nineties and which continues today ---the disappearance of Canadian Family Doctors.