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Are Pay-for-Performance Programs a Threat to Medical Professionalism?
- Richard L. Neubauer, MD; and
- Lois Snyder, JD
- From Alaska Native Medical Center, Anchorage, AK 99508, and American College of Physicians, Philadelphia, PA 19106.
IN RESPONSE:
We appreciate Dr. Metoyer's thoughtful comments, many of which the American College of Physicians Ethics, Professionalism, and Human Rights Committee agree with in the College's pay-for-performance position paper. We do not agree, however, with her conclusion that, in some regards, pay-for-performance programs are inherently unethical. Every payment system creates incentives and potential conflicts of interest, such as the incentives in fee-for-service payment to increase care or the incentives under capitation to do less rather than more. The College believes pay-for-performance programs have promise if they can be focused on patient perspectives …
