Sunday, July 20, 2008

Daft Idea of the Week - Performance Bonuses for Surgeons

Of all the daft ideas I've heard this week - and there have been a few - this has to be the daftest. Complex surgery on human beings can't really be given the piecework approach. There's also an argument to say that senior surgeons are paid enough, if not more than enough anyway. Recovery from surgery of any kind is determined by a huge number of physical, environmental and psychological factors. The surgeon may do the fiddling about with your internal organs, but it's nurses who are responsible for your hour to hour care, auxiliaries and domestic staff who keep the hospital clean, and physios and other specialists who aid your recovery. I don't see any mention of them being included in the bonus scheme.

Patients' groups are up in arms about this proposal, not surprisingly. Who's going to want to perform the high risk procedures with high mortality rates under such a system? Would they get forgotten as managers incentivise conditions with the longest waiting lists?

If the objective is to provide the best possible service to patients, surely we need to ensure that everybody involved in patient care is fairly rewarded for the job they do on a day to day basis and ensure that we have enough staff to enable all the required operations to be carried out in a reasonable timescale?

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