title: ["I do the right thing only against payment": A critique of pay for performance in psychiatry].
abstract: This paper takes a critical look at pay for performance (P4P) as a model for introducing new incentives in psychiatry. This model is to be seen as a tool of commercialism, and such a restructuring of psychiatry represents a wide-reaching political maneuver which actively introduces economical parameters into the field and will have a great impact on psychiatry. P4P starts with the false premise that medicine has to be structured like industry. This premise is false because psychiatry has to do with relationships to patients, and not with the production of a product. Therefore, it is essential to reflect critically upon the premises and consequences of P4P for psychiatry. Only this critical reflection can help psychiatry to keep its identity as a humane service for suffering people.
authors.affiliation: Lehrstuhl für Medizinethik, Institut für Ethik und Geschichte der Medizin, Albert-Ludwigs-Universität Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg i.Br., Deutschland. maio@ethik.uni-freiburg.de.
authors.forename: G
authors.initials: G
authors.lastname: Maio
mesh_terms: D005858:Germany; D018803:Models, Economic; D017146:Models, Organizational; D010816:Physician Incentive Plans / Q000191:economics*; D010817:Physician-Patient Relations; D011570:Psychiatry / Q000191:economics*; D012052:Reimbursement, Incentive / Q000191:economics*
keywords: Industrialization of psychiatry; Intrinsic motivation; Medical ethics; Medical service; Pay for Performance