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Pay-for-Performance and Accountability
TO THE EDITOR:
How many clinical outcomes are actually based on physician care? This is the basic question we need to address before we can discuss the pay-for-performance initiative. A well-designed study on managed care patients clearly indicated that patient factors substantially influenced outcomes (1). The cost of medications and the age and sex of the patients were among many things that determined whether patients decided to follow their physicians' advice. It is also well known that racial and ethnic disparities already exist in our health care …
