By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    photo of hands with blue veins
    8 Proven Tips on Finding Difficult Veins
    November 12, 2021
    tips for getting over the pandemic blues
    4 Proven Ways to Get Over the Pandemic Blues
    February 22, 2022
    medical industry innovations
    How is CNC Machining Transforming the Medical Industry?
    June 2, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Doctors on Google: Manhattan Research Survey 2012
    July 23, 2012
    HealthCare’s Need for Transparency Goes Far Beyond Pricing
    December 10, 2012
    Medicare Payments to Providers Are Carved, Sliced and Chopped by Sequestration
    March 25, 2013
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Pay for Performance Attacks Medical Quality: Lincoln Lucks Out
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Pay for Performance Attacks Medical Quality: Lincoln Lucks Out
BusinessHealth Reform

Pay for Performance Attacks Medical Quality: Lincoln Lucks Out

Michael Kirsch
Last updated: July 8, 2012 3:22 pm
Michael Kirsch
Share
4 Min Read
SHARE

Why does Pay for Performance (P4P) make most physicians reach for Maa

Why does Pay for Performance (P4P) make most physicians reach for Maalox? I have devoted a good portion of this blog’s real estate to dismantling the fallacy that pay for performance improves medical quality. It’s easier to argue that this clumsy and robotic approach diminishes medical quality by incentivizing physicians and hospitals to game the system to maximize their quality scores.

When an irritating high school student raises his hand and annoys the teacher with the inquiry, ‘is this gonna be on the test?, it is a forerunner of the concept of pay for performance. The Ivy League seeking student won’t study material that he knows won’t appear on the exam. Similarly, physicians and medical institutions will focus their attentions on achieving those outcomes that will be measured and graded, which might be at the expense of patients who ‘are not on the exam’. For example, if irritable bowel syndrome isn’t being measured, but GERD is, then will these patients be treated the same? Beyond this, I reject the concept that medical quality can be reliably measured and quantified.

There’s a Renaissance painting hanging on a museum wall. Is it a masterpiece? Since it’s tough to measure and judge art, should we use a ruler to measure the perimeter of the frame and consider this to be a quality surrogate? Absurd, yes. But, if you buy into this fantasy, it makes it a lot easier to measure quality.

More Read

medical inflation
Is Medical Inflation Coming Back to Bite Us?
FDA Approves Roche (Genentech) Skin Cancer Drug–Zelboraf
America Has A Health Care Paradox
From the Health Innovator’s Collaborative: Providing Better Care with Less
The Concerns of BYOD in Healthcare

Why shouldn’t we apply the P4P concept into other professions.  Not surprisingly, folks won’t speak out against pay for performance until they are sagging under its yolk. Consider the following P4P extensions.

  • Teachers’ quality is judged by students’ attendence
  • Musicians’ quality is graded by ticket sales
  • Congressmen’s quality depends upon approval ratings
  • Meal quality depends upon weight
  • Book quality depends upon # pages

This is the same silliness that is being imposed on the medical profession. Sure, they can present P4P to the public as rational policy, but no slogan can sanitize the scheme. Of course, serious reforms in the health care system are needed, including a hard look at how physicians and hospitals are reimbursed. Too often, the interests of the medical community and those we serve are misaligned. However, to force P4P on us and then use the results to reward or punish us financially is capricious, unreasonable and fallacious.  Perhaps, even the goverment knows this is not a true quality initiative, but a poorly disguised cost control cudgel.

Is this blog post any good? How can we grade it? By the number of comments? Number of retweets? Why agonize. Let’s all agree that a blog post’s quality can be measured by the word count. Here’s my suggested metric.

          # Words               Quality

               1 – 100                                    Poor

               101- 199                               Mediocre

               200 – 300                            Lousy

               301-400                                Below average

               >400                                      Superb

If the Gettysburg Address is graded using the above schema, we would see how overrated this speech is. The reason we have elevated this speech into the pantheon of American rhetoric is because we didn’t have an available grading tool that would have shown us that Lincoln’s remarks were ordinary political drivel.  Some presidents have all the luck. 

Let us hope that Pay for Performance shall perish from the earth. It is altogether fitting and proper that we do this.

TAGGED:pay for performance (p4p)
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

Medical Advancement: Innovation to Sports Injuries Treatments

May 16, 2016
It is no surprise that the most trusted information sources were doctors and nurses and other healthcare providers. Newspapers, corporate websites and online search engines comprised the next tier of trust, getting the vote from about 1 in 5 respondents.
Business

Consumers Prefer Marketing Collateral by Post to Email

January 20, 2014

Five Ways to Reduce Errors in Pathology Synoptic Reporting

October 12, 2014
Image
Business

Healthcare App ZocDoc Cracks A Top 100 List

September 19, 2013
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?