title: Pay for performance and medical professionalism.
abstract: Health care delivery systems are widely studying and implementing physician pay for performance (P4P) initiatives to improve quality and control costs. However, the increasing focus on quality-driven financial incentives has some troubling implications for medical professionalism. This article examines the P4P concept in light of a notion of medical fiduciary professionalism that dates back to the 18th-century Scottish physician John Gregory. Gregory's principles serve as a framework to assess the appropriateness of P4P initiatives in disseminating the principles of high-quality care without damage to professionalism, the patient-physician relationship, and access to care for all patients.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio 44118, USA. marissa.hendrickson@uhhospitals.org
authors.forename: Marissa A
authors.initials: MA
authors.lastname: Hendrickson
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D010817:Physician-Patient Relations; D011364:Professional Practice / Q000592:standards; D011785:Quality Assurance, Health Care / Q000191:economics* / Q000592:standards; D012052:Reimbursement, Incentive; D014481:United States