For stroke this is incredibly simple. Once the bleed is stopped or the clot removed any additional neurons that die, the hospital pays the patient $1000 a dead neuron and the doctors don't get paid at all. If the patient doesn't get 100% recovered the doctors and therapists don't get paid. Pay for performance will work! Painful at first but survivors don't care about your financial pain since you didn't care about their recovery since you got out of medical school.
Enhancing Value and Well-Being; The Basket of Motivators Framework for Aligning Neurology Clinical Practices With Performance Outcomes
Abstract
Purpose of Review
Physician
burnout, which is prevalent in neurology, has accelerated in recent
years. While multifactorial, a major contributing factor to burnout is a
payment model that rewards volume over quality, leaving physicians
overburdened and unfulfilled. The aim of this review was to investigate
ways of reducing burnout while improving quality-based outcomes in a
value-based health care model.
Recent Findings
Burnout
affects researchers, educators, clinicians, and administrators in all
fields and tracks, but neurologists experience some of the worst burnout
rates among specialties. Transitioning to a value-based health care
model, which rewards quality and outcomes over volume, may contribute to
reversing the burnout trend. However, this requires that physicians
feel valued in the workplace in ways corresponding to their preferences.
We propose to stratify neurologists using the “basket of motivators”
framework, which operates multiple individual-based and team-based
motivators including balance among work responsibilities, work-life
balance, institutional pride, self-actualization at work, work
environment, and finances. By tailoring individual-based and team-based
financial and nonfinancial incentives, neurologists are empowered to
work at the top of their license to provide high-impact clinical care
while combating the most prominent causes of burnout.
Summary
To
address the neurologist burnout epidemic, a transition to value-based
health care is needed that rewards quality-based performance outcomes
through both individual-based and team-based approaches that apply
financial and nonfinancial incentives. Understanding the underlying
motivations behind neurologists' drives to work can inform tailored
incentives that allow neurologists to provide value to their patients
and feel valued by their organizations.
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