The Siren Song of Physician Incentives: Avoiding the Rocks

As the United States attempts to reform its health care system, various incentive programs are playing an increasingly important role. In this review, the primary dynamics that drive the rise of incentives in health care management are discussed. Increasingly well-designed studies on the impact of incentives on outcomes continue to yield variable and, at times, unexpected results. The incorporation of incentives into the overall process of organizational cultural change is an important tool but one with significant limitations.