The Reward System that operates for Health Care Professionals in NSW – 1

In almost every situation there’s what can be called a “reward system.”

Peter Drucker, the famous management writer, often used to refer to it. And similarly, we have a book in which the writer calls this the “the greatest management principle in the world – “The things that get rewarded get done.” In other words, in most situation there are factors which determine which ways of doing things benefit people and organisations the most.

This is demonstrated by this.

One of our readers reports that he was referred to Ophthalmologist A for help with his double vision, and spent 3 or 4 hours in her rooms seeing her and her people and learnt nothing. He kept being told that they needed to get to the bottom of the causes of his double vision as they could be VERY serious and that this was a long and difficult task. This is part of one of the emails he got.

Subsequently, he saw Ophthalmologist B, who, after getting the history of his double vision from him, in just a few minutes told him, (1) that it was most unlikely that it was due to anything serious, but, if he wanted to make sure, he could have an MRI of his brain, and (2) that he could solve the practical  problems of his double vision by getting prisms in his glasses.

So he had an MRI of his brain, and it was clear, and he got prisms in his glasses, (which neither Ophthalmologist A nor any of her people had mentioned in all the time he’d spent with them,) and the way in which they helped him was nothing short of miraculous.


Ophthalmologist A, of course. She would have made FAR more money than Ophthalmologist B.

And she could have made a lot more, if she’d been able to talk him into having cataract surgery, which she clearly set out to do, amongst other things telling him it was “clinically indicated” – see this in one of the emails she sent him.

(Our reader tells us that he’s recently seen an Optometrist and an Ophthalmologist, and they’ve both told him that he STILL doesn’t need cataract surgery – more than 8 years after receiving this email.)

A very important aspect of this is the contribution government organisations and people make to the reward systems under which health care professionals, for instance, work.

Our reader reports that, after all the above, he made a complaint to the NSW Health Care Complaints Commission about Ophthalmologist A, contrasting how he’d got on with her with how he’d got on with Ophthalmologist B. And guess how he got on?

He got something back along the lines of, “Oh, different practitioners have different approaches to things, and there’s nothing to indicate that the approach Ophthalmologist A took was any better or worse than Ophthalmologist B’s approach.


With the reward system that exists in New South Wales for health care professionals, why would any of them in their right mind do the right thing, as Ophthalmologist B did, and involve our reader in a consultation that only lasted less than 30 minutes, when he could have kept him in his rooms for 3 or 4 hours in the way that Ophthalmologist A did. Fortunately, Ophthalmologist B did, regardless – but Ophthalmologist Bs are few and far between.

And with people like Sue Dawson being at the head of institutions like the NSW Health Care Complaints Commission, things are unlikely to get any better, extremely unlikely!

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