Get what you pay for I suppose it's no big surprise that people do a better job when their paycheck is on the line. But it's still a little disconcerting to know that some of those people are your doctors. A recent study published in the journal Health Services Research found that patients who saw physicians taking part in a "pay-for-performance" incentive program received better care than those who saw physicians not participating in the program. Enrollment in the program was completely voluntary for physicians, and their actual salaries weren't affected, but they did have the potential to earn bonuses based on their ratings. The physicians were evaluated in several categories, including patient satisfaction. Patients were asked to rate their access to the physicians' care, the physicians' level of communication, and the medical services provided by the physicians. The higher the ratings, the higher the bonus offered to the physicians. I know that, to some degree, most people are motivated by rewards -- particularly monetary ones. But isn't medicine supposed to be one of the more selfless professions? Shouldn't doctors be doing the best work they can regardless of what's in it for them? Of course, looking at it from another perspective, doctors who would be willing to participate in such a program are probably the ones already putting forth that extra effort to begin with. Whether or not your own doctor is participating in such a program, you can still take some time after each visit to think about the same parameters the patients in this study considered: Do you have adequate access to him when you have a question or need an appointment? Does he communicate well (and that includes listening to what you have to say)? And are you satisfied with the quality of service you receive from him? If the answer to any one of these questions is "no," you may not have the power to affect his salary, but you can certainly take your business -- and your health -- elsewhere. Sources:
"Doctor 'pay-for-performance' improves patient care, study shows," ScienceDaily (www.sciencedaily.com), 1/11/08
"Patient outcomes and evidence-based medicine in a preferred provider organization setting: A six-year evaluation of a physician pay-for-performance program," Health Services Research 2007; 42(6p1): 2,140-2,159 | 
