As more doctor pay is being tied to patient satisfaction and “outcomes,” a recent Forbes article argues that “It’s only a matter of time before physicians will see the bulk of their compensation tied to quality measures.” To prepare for this pay-for-performance apocalypse, the article cites Medical Group Management Association (MGMA) CEO Haylee Fischer-Wright, MD, who urges physicians to “build data analyses” and take steps to “keep their patients satisfied.”
These sound bites might go over well in a boardroom (assuming there are no physicians present). But let’s consider two little problems. First: Neither pay-for-performance (P4P) nor patient satisfaction has been shown to improve patient outcomes. Secondly, and perhaps more importantly to shareholders, neither have been shown to save money.
P4P sounds great in theory — it’s the old “carrot and stick” routine, or something that psychologists call “extrinsic motivation.” Give doctors more money for good work, and they will work harder, do a better job with patients and voila! Better patient outcomes. Threaten them with pay cuts or other forms of punishment for poorer results, and they will fall into line.
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