Pay for service or for outcome?

The WSJ Health Blog notes a phenomena that highlights a concern of both doctors and teachers. The issue is how to determine how they should be paid and for what.

The prospect of linking doctor pay to patient outcomes makes lots of doctors nervous. Many doubt that a payment system can accurately account for important differences between patients. And they worry that any changes will only mean more paperwork and administrative hassles.

You can take this same paragraph and substitute ‘teacher’ and ‘student’ for doctor and patient and it will still be accurate.

The issues of differences in clientelle and paperwork are only visible parts of a much more complex phenomena. These service based occupations depend very much upon relationships and that means that success will depend upon not only objective factors but also subjective factors. An answer is not clear and cleanly defined. There will be no simple solution and trying to find one can be fraught with potential for damage.

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