Performance and talent management in healthcare is a big issue. Yesterday, an NYT article talked about the incentive structure in medical professions. Essentially, healthcare professionals are paid to “perform tests and to do surgery and to dispense drugs.” Not to make correct diagnoses and save lives. The correct incentives are misaligned with pay and “You get what you pay for,” said Mark B. McClellan, who runs Medicare and Medicaid “And we ought to be paying for better quality.”

Remarkably,  “studies of autopsies have shown that doctors seriously misdiagnose fatal illnesses about 20 percent of the time.”  Believe it or not, this is the same rate as in the 1930’s. Almost 80 years has gone by, and even though we’ve made amazing progress in medicine, doctors still make bad diagnoses fairly often. But things may be looking up. According to the article:

There are some bits of good news here. Dr. McClellan has set up small pay-for-performance programs in Medicare, and a few insurers are also experimenting. But it isn’t nearly a big enough push. We just are not using the power of incentives to save lives. For a politician looking to make the often-bloodless debate over health care come alive, this is a huge opportunity.

Why Doctors So Often Get It Wrong – New York Times.

Another NYT article from last year on the topic of pay-for-performance in healthcare:

“By the end of this year, more than 600,000 Medicare recipients will be in test programs that pay doctors and hospitals bonuses for achieving better results, like increasing the number of diabetic patients whose blood sugar is under control.”