If you have been reading this blog over the years then you would have known that I have compared the No Child Left Behind crusade in teaching to the Pay-for-Performance one going on in medicine. Basically, paying professionals based on the testing results of their students or the chol/BP/glucose results of the their patients can lead to gaming the system. For the former, please check out this article on much cheating was going on in Atlanta. Basically what they were saying to themselves was, “This rating of performance is such a joke we are going to cheat the system in our favor” and they did. For healthcare, expect doctors to the same thing. It is as easy as changing the blood pressures that your medical assistant took or, even better, firing those patients that make your scores look bad. Trust me, it’s coming and that is no April Fool’s Day joke.
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