Why your stroke doctor should be paid based on your outcome

 Double rant rating here:

This is one of the keys to getting better stroke rehab. Our doctors have no incentive to find better ways of doing rehab. And I know this is going to be controversial. So if you have a response that doesn't just attack me for sticking my opinion into medical matters, I will print it.

 Lets put it baldly out there: Stroke rehab is a failure, look at the statistics, 10% full  recovery is godawful.
http://oc1dean.blogspot.com/2011/05/stroke-recovery-statistics.html
http://oc1dean.blogspot.com/2012/05/5-things-physicians-can-learn-from.html

1. I think maybe doctors and teachers might be the only professions left that are not compensated based on results, you write up objectives and at the end of the year justify your rating based on how close you came.
2. If we have results-based therapy;
     A. We'll get a specific damage diagnosis because a baseline would be             needed to prove improvent.
    B.   We'll get doctors asking their stroke associations to provide them with concrete proven therapy protocols.
   C. We'll get translation from clinical research to therapy much faster.
   D. Stroke patients will actually have a say in the way stroke rehab is provided thru their doctors.
   E. Stroke survivors could look up with a factual basis those that provide the best recovery possibilities. None of this crap, 'We're certified by the Joint Commission' (A great place to hide behind).
   F We'll get faster and much better hyperacute therapies that stop the neuronal cascade of death because stopping neuronal death is much easier than therapy after the fact.
  G. Followup will occur rather than being released to home after 2-3 months.
  H. We'll actually get written stroke protocols.


Have at it, I want to see some well-reasoned arguments  against this or your  own proposal that would accomplish the same thing. Prevention will not be accepted as a viable answer. Copying the crap from the WSO does not count.

Only one rant off because this rant needs to be left open.

A doctor blogging disagreeing about pay for performance, I disagree.

Some performance measures make sense, but P4P does not