In this week's Journal of the American Medical Association, Drs. Rodney Hayward and David Kent offer doctors "6 EZ Steps to Improving Your Performance," a snappy how-to guide for "winning the pay-for-performance game."  (Accessing the article requires a paid subscription.)  Mind you, each step is just dripping with sarcasm and actually outlines how present P4P incentives can deter doctors from putting their patients first.  

Here are their 6 EZ steps:

• "Embrace your performance measures" because they're far simpler than having to address the individual needs of your patients.
• Focus on the quality score and don't waste time with those pesky patients with the more vexing medical issues and circumstances.
• Make sure you "diagnose generously" so that you don't leave out those with "diseases" that are easy to maintain.  Otherwise, your average might suffer.
• Don't be afraid to get "creative" when treating patients.  For instance, you might need to take a patient's blood pressure 2 or 3 time to get the right measure.
• If a patient's problems escalate, don't let them weigh down your average.  Instead, dump them to another doctor.
• Lastly, for goodness sake "practice in the suburbs" where people have "ready transportation, good social support, and a substantial trust fund."