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New York City adopts pay for performance medical program

It sounds like a good idea: doctors will be paid based on the quality of their work, but there are some who believe this pay for performance program won't be make as large of an impact as many may think. New York City is just one city in the country that is tying performance-based metrics to pay in an effort to reduce medical malpractice. One of the concerns, however, is that the bonuses to encourage doctors to do better are not that high. When doctors make a lot of money as it is, the 2.5 percent bonuses that they will receive for better care is not significant enough to actually cause widespread reform.

In addition, some critics believe that once doctors know what they are being measured on, they are more likely to manipulate the results for their benefit. Doctors and hospitals will take what measures they can to make it appear that patient satisfaction is on the rise.

Instead of using performance-based metrics, one physician has suggested that it would be better to appeal to physicians' professional sides. This idea is not without its own testing; the physician is responsible for reducing infections with catheters after he issued a short checklist for doctors and nurses. By following the list, they could cause a lot fewer infections. In addition, he told the hospital personnel that the infection statistics would go public, causing a greater incentive to reduce medical malpractice.

Unfortunately, there needs to be some kind of incentive to doctors to create safer and better results for New York patients. Many people may think that because doctors have the ability to save lives that they will do everything in their power to do so. Sadly, some doctors rely on paid incentives and other kinds of benefits before they are willing to help protect their patients' health and wellbeing.

Source: The New York Times, "Carrots for Doctors," Bill Keller, Jan. 27, 2013

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