With apologies to one of the most wonderful movies – Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb.

I am fortunate to know Dr. Rod Hayward.  He is a wonderful researcher at the University of Michigan.  He sees the world without prisms.  He is irreverent.  He understands all the problems with P4P as currently constructed.

He has a wonderful piece in JAMA, ripe with sarcasm.  I could not stop laughing.  For those with a subscription – 6 EZ Steps to Improving Your Performance (or How to Make P4P Pay 4U!)

Their extract

Pay for Performance is upon us! Already, the naysayers have begun declaring how terrible this will be for doctors. As a primary care physician, perhaps you believe that, given the myriad urgent demands and financial challenges of primary care, dealing with new paperwork and regulations will be difficult, if not impossible. Thankfully, this is not the case! In fact, winning the pay-for-performance game is actually quite easy and can also be a lot of fun!

All you need to do is follow our 6 EZ steps to improving your performance measures so that your overseers can enjoy the brand of health care they so earnestly desire.

Step 1: Learn to Love Your Performance Measures
The first and most important step in the P4P game is to embrace your performance measures. Remember, the guiding rule in developing performance measures is to "Measure . . .