Hospital Tests 'Warranties'

Improving the quality and efficiency of health care will involve all the professionals involved in delivering care. Physicians are mentioned most often because they lead the teams that provide care.

"Physician pay for performance" is in some ways shorthand. It is the performance of not just the physician but those working with him or her that is to be rewarded. Moving to a higher quality more efficient health care system will likely involve new roles for nurses and other non-physician professionals. There will be more responsibilities that they take on independently. It will be important to ensure their performance is properly recognized and rewarded.

Excellent point! Clinical care is a team-based process by definition and doctors are far from being the only "important" members of that team. The ProvenCare approach really is a team-based pay-for-performance system.

All of our staff, including doctors, are salaried. Most all have performance goals that impact their performance appraisals and ultimately their future compensation. Although we believe we have made a good start, we need to do even more to extend this concept across all staff, just as you suggest.