VIEWPOINT Does Measurement Suppress Motivation? in achieving those results, from more complex problem Christine K. Cassel, MD solving. Focusing on specific outcomes does not reward Sachin H. Jain, MD, MBA skills or result in managing complexity, solving prob- lems, or creativity. Indeed, Pink suggests such reward URING THE PAST DECADE, THE MEASUREMENT OF systems will undermine these desirable attributes. Trans- physician performance and offering incentives as lating the ideas of Trisolini and Pink into a clinical medi- a means of improving care have been the focus cine context leads to several recommendations: pay phy- Dof many governmental, private, and profes- sicians a rewarding yet reasonable salary rather than sional groups. Performance measurement systems typi- piecework rewards, provide a direct ability to influence cally use discrete, validated clinical measures. Even though patient outcomes, and offer a continual sense of accom- the results of these approaches have thus far been equivo- plishment and recognition. These would represent a cal, performance measurement is already being firmly es- more effective approach to motivating performance than tablished in health care. The Affordable Care Act contains specifically paying for production functions. requirements for the Centers for Medicare & Medicaid Ser- Measuring performance is important, particularly
JAMA – American Medical Association
Published: Jun 27, 2012
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