Intended for healthcare professionals

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Rapid response to:


The impact of removing financial incentives from clinical quality indicators: longitudinal analysis of four Kaiser Permanente indicators

BMJ 2010; 340 doi: (Published 11 May 2010) Cite this as: BMJ 2010;340:c1898

Rapid Response:

Financial incentives. our own motivations?

Financial security is indeed important. Once that is obtained, then
self motivation and vocation should play a large part in performance.

Do financial incentives take away such vocational focus, and in the
long term are they counter productive. maybe it sepends...

The glycaemic control arm would argue for Doctors being
clinically/vocationally motivated (was improving prior to incentives), the
screening data against (dropped after incentives removed).

Perhaps we are more vocationally enthused (or convinced?) by
glycaemic control than screening. Maybe it’s the administrative issues
behind screening that are the differance, wheras HbA1c control is more in
the hands of the physician (more ownership).

Until we know more about our motivations, such studies are too full
of confounders to be used to produce policy, though doubtless governments
will indeed use them for this.

Competing interests:
None declared

Competing interests: No competing interests

19 May 2010
M C Aley
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