协作医疗(coordinated care)和GP这对矛盾：在FFS存在的前提下，GP不愿意协助医疗(因为1要分GP的钱，2降低GP的自主权)，病人不愿转诊或多点诊疗(因为1多花 钱看医生，2多交通成本和时间、精力)。所以瑞士一个discrete choice experiment(测量人的偏好的工具)发现，要多给GP40%的费用他们才愿意协作，而病人也要降低premiums才愿意接受协作诊疗。这事不仅 在US是个问题，在国内的两个政策"加强基层医疗和社区卫生"与"加强转诊体系建立"看起来也用得上。
As long as fee-for-service payment systems remain an option, general practitioners will be reluctant to embrace coordinated care because it would give them less autonomy in how they practice. A study in Switzerland indicates that general practitioners will require a pay increase of up to 40 percent before they are willing to accept coordinated care, and a similar study found that Swiss consumers wanted a substantial reduction in premiums to accept it.
source：Zweifel P. Swiss Experiment Shows Physicians, Consumers Want Significant Compensation To Embrace Coordinated Care [J]. Health Affairs,2011,30(3):510-518.
