Linking the performance of health care professionals to their compensation is a good start but unlikely to work alone in changing behavior. Health care professionals will continue their current behavior because of some of the following reasons.
They don’t know what they are supposed to do to change.
They don’t know why they should change.
They don’t know how to change.
They think something else is more important.
There are no positive consequences for them to change.
There are no negative consequences for them not changing.
They are rewarded for not changing.
They are punished for changing.
If the health care system does not provide what professionals need to change, they will not change or they will change in undesirable ways. Compensation will not make a significant difference. Pay-for-performance schemes cannot replace the other changes necessary for improving the quality of health care -- they can only support them.
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