To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
Physicians have a duty to learn the facts and use their medical expertise to allay patients' fears rather than order unnecessary tests when a certain disease or condition receives a great deal of media coverage.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
Presymptomatic genetic testing for neurodegenerative diseases can help patients make effective treatment decisions, but the medical profession needs to ensure that the increasing use of the tests is done responsibly.