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Contact: Steve Majewski
American College of Physicians

Panel: Properly designed pay-for-performance models can support medical professionalism

Expert panel convened by the American College of Physicians analyzes the relationship between P4P incentive programs and medical professionalism

PHILADELPHIA, March 16, 2010 -- An expert panel convened by the American College of Physicians (ACP) says that properly designed pay-for-performance (P4P) programs can strengthen the relationship between physicians and patients and increase the likelihood that physicians will deliver the best possible care. The panel's analysis appears in the March 16 issue of Annals of Internal Medicine.

"Concerns about the conflicts between medical professionalism and pay-for-performance have been based primarily on theories about the tension between external motivation and self-interest and the internal motivation and self-restraint that characterize professional expectations," said panel member Amir Qaseem, MD, PhD, MHA, FACP, a senior medical associate with ACP. "We believe that physicians should play a key role in defining and evaluating P4P programs that are compatible with professionalism."

The ACP-led panel of experts in clinical medicine, law, management, and health policy met six times to examine the relationship between medical professionalism (a code of conduct that under ideal circumstances is adhered to by all professionals) and P4P incentive programs (various financial incentive programs that differ in eligibility requirements, selection and scope of measures, formula for determining payment, and magnitude of payments).

Using the Charter on Medical Professionalism (http://www.annals.org/content/136/3/243.full.pdf) -- developed by the ACP Foundation, American Board of Internal Medicine Foundation, and European Federation of Internal Medicine -- as a framework, the panel organized the Charter's 10 professional responsibilities around four themes especially pertinent to P4P:

By systematically considering the potential interactions between P4P and each of the themes, the panel concluded the following:


The views expressed in the paper are solely those of the individuals on the advisory board and do not represent the policy of the American College of Physicians.

The American College of Physicians position paper, "Pay-for-Performance Principles that Ensure the Promotion of Patient Centered Care," is available at http://tinyurl.com/yjq2pzo.

About the American College of Physicians

The American College of Physicians (http://www.acponline.org/) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 129,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter (http://twitter.com/acpinternists), Facebook (http://www.facebook.com/acpinternists), and LinkedIn (http://www.linkedin.com/groups?gid=867307&trk=myg_ugrp_ovr).

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