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- Marissa A Hendrickson.
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio 44118, USA. marissa.hendrickson@uhhospitals.org
- Qual Manag Health Care. 2008 Jan 1; 17 (1): 9-18.
AbstractHealth 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.
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