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It’s about more than money: financial incentives and internal motivation

¹ Professor of General Practice, National Primary Care Research and Development Centre, University of Manchester, Manchester, UK
² Professor of Social Policy, School of Social Sciences and National Primary Care Research and Development Centre, University of Manchester, Manchester, UK

Correspondence to:
Professor M Marshall
National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, UK; martin.marshall@man.ac.uk

Keywords: financial incentives; internal motivation; general practice; quality improvement

The first 150 words of the full text of this article appear below.

High profile initiatives such as the incentive programme introduced by the Centre for Medicare and Medicaid Services in the US¹ and the new general practitioner contract in the UK² highlight the enthusiasm of policy makers for using financial incentives as a way of improving the quality of care. This enthusiasm is understandable, given the burden of healthcare costs experienced by most countries. It makes sense to ensure that resources are targeted on buying desirable behaviours from health professionals and producing beneficial outcomes for patients.

But is the fascination with financial incentives based on sound empirical evidence? At a general level the answer is a guarded "yes". We know from observational studies that the way in which doctors are paid is associated with particular patterns of clinical behaviour. For example, doctors paid under fee-for-service schemes undertake more visits and conduct more investigations than those paid under capitation schemes.³ In . . . [Full text of this article]

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