Source] In Quebec, doctors who administer flu shots can earn close to $5000 a day. An audit found that the Government has spent a whopping $416 million in over-payments to the area’s doctors over the last five years. If that doesn’t tell you how big this business is, I don’t know what will. The situation is tricky, though, because it doesn’t require a doctor to administer the shot. But when a doctor does do the work, they are paid well. According to cjad.com, doctors can see 250 patients a day at a rate of $20 to $100 per patient.

It is a loophole in a sense. In a document (French) from 2007, it specified that doctors could gouge the system so long as they “evaluated the patients” and “were present at time of the immunization.” It doesn’t even seem as if they need to be administering it if they don’t want to do so. Clearly, this isn’t practical application at all. How could a doctor reasonably “evaluate” 250 patients per day?

The peculiarity of the situation means doctors, once again, being incentivized to push patients in directions which are aside from the patient’s best interest. Clearly, there isn’t much reasoning for a doctor to be present during a flu shot; the protocol is simple in the administration. The compromise actually comes from the revenue driven by the volume of patients. In this case, what doctor wouldn’t support every person getting the immunization? This is a business model, not a health prevention model. It takes less than a minute to give a flu shot; doctors can quickly turn patients every few minutes.  While I understand that people should be paid for their work, they should not be incentivized to turn patients like waiters turn tables during dinner. This is an egregious conflict of interest.

When it comes to the flu shot, both the doctor and pharmaceutical company are now incentivized to push patients to receive the shot. They are also incentivized to push for more mandatory legislation, have employees who refuse these shots fired, and lobby politicians to protect their interest. The influenza vaccine is a failure when it comes to preventing the flu, but it is a success when it comes to marketing. The more people see items like this, the more hope we have for change.