Friday, January 26, 2007

Is pay for performance akin to the radical mastectomy procedure?

Check out the latest issue of the New England Journal of Medicine and read the article by Lindenauer, et al "Public Reporting and Pay for Performance
in Hospital Quality Improvement." Interesting, interesting results...

Also suggest y'all read the editorial "Pay for Performance at the Tipping Point" by Arnold M. Epstein, M.D. As Doctor Epstein points out in his editorial:

Given this dearth of solid evidence, it seems apt to compare our adoption of pay for performance with our adoption of new surgical procedures or medical therapies. Many of my clinical colleagues would insist on hard evidence documenting efficacy before endorsing a new therapeutic approach. They cite sobering stories of what can happen when we introduce new approaches prematurely. Consider, for example, the numerous surgical procedures or medical therapies — including radical mastectomy for women with early-stage breast cancer and hormone-replacement therapy for postmenopausal women — that were diffused widely before solid evidence of their relative efficacy was available, only for us to learn later that they were, at best, no more effective than alternative therapies or, at worst, harmful.8-10 If pay for performance were a therapy, its rapid diffusion thus far would have to be considered premature.
Click here to access these free, early release articles. Thanks, NEJM!

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