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Pay‐for‐virtue: an option to improve pay‐for‐performance?
Author(s) -
Buetow Stephen,
Entwistle Vikki
Publication year - 2011
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2011.01722.x
Subject(s) - virtue , epistemic virtue , neglect , virtue ethics , pay for performance , psychology , social psychology , law and economics , medicine , health care , law , sociology , nursing , political science
Pay‐for‐performance schemes reward standardized professional behaviours associated with effective care. However, they neglect the significance of virtue and devalue and erode professional motivation based on virtue. Pay for training to cultivate virtue, and/or pay‐for‐virtue, may mitigate these dangers. Although virtue is typically considered its own reward, and the assessment of virtue is problematic, pay‐for‐virtue could involve (1) stringent checks on the appropriateness of the standardized care currently rewarded by pay‐for‐performance for individual patients or (2) pay for indicators of virtue. These indicators could be based on virtues identified from a framework of universal virtues and through logical inferences from features of practice. It is possible that pay‐for‐virtue could ultimately strengthen health professionals' intrinsic motivation for good practice, but this and the broader effects of pay‐for‐virtue would need careful investigation.