Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Performance related pay
- Peter S L Barling (5 October 2007)
|
|
|||
|
Peter S L Barling, GP Oswestry SY10 7HR
Send response to journal:
|
This argument may come and go like the tide and yet both performance related pay and straight salaries have their strong points,as well as weak points.A salary may provide a secure financial back ground for a physician leaving his or her energies for their work.However,it also allows the indolent an easy passage through a working life especially when the initial joys of the job have paled with time. Performance related pay allows incentives which can provide a driving force.It can also provide for political intrusion in attaining aims for policy such as the quality and outcome framework.Performance related pay can also result in over treatment and questionable overperformance. I have worked in both systems,in Canada and the UK.I remember a patient who had three separate claims for hysterectomy over a few years.Overly zealous surgery,and extended follow up consultations for minor illness.I also can see the sloth that can invade the NHS.Interestingly ,we now have in the NHS some of the overtreatment mechanisms for increasing budgets.The double follow up of otitis externa in A&E departements springs to mind. A balance of the two concepts might (or not)be the answer.A performance related pay which increased in an exponential curve could provide a good average pay,a poor pay for the indolent,and a controlled increase for the hard worker.It would also allow for political objectives,as well as giving warning of of overtreatment.Objectives could be changed annually in keeping with ever changing medical opinion.Rigid quality and outcome framework taking no account of changes in geriatric care could be replaced. Will we ever get it right. Competing interests: a GP |
|||