We appreciate your response to our article on overtesting.1 Like in Saskatchewan, British Columbia physicians receive annual printouts of the costs generated per patient and their rank scores in relation to their peers. Sadly, like in Saskatchewan, few British Columbia physicians seem to look at these reports. Even fewer physicians discuss their results with their peers or with those who collect the metrics. This absence of interest is perhaps a reflection of the current delivery model of primary care, in which family doctors receive public funding to deliver health care as a small, privately run business. In this model, the accountability is to both professional integrity and running the business. Broader system accountability is far less on the radar. Such reports are an interesting potential focus for collective self-appraisal, and we appreciate you pointing out their existence.
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Competing interests: None declared
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