Response by Angela Mandas and Terrie Sekins

As supervisors in a large metropolitan hospital, we are faced with the challenge of reviewing the performance of clinical staff. One criterion for judging employee performance is productivity. Clinical productivity determines the scale for each employee's annual performance review. If they accomplish a predetermined level of productivity they receive an incentive in the form of an increase to their base pay. If they do not meet the standard, then salary remains the same. As healthcare changes and patients are referred for services less often or are discharged quickly from hospitals, it can be difficult to meet high productivity standards. Incentives to increase work performance are appropriate, but this approach can be abused when it serves to increase revenues rather than to maximize clinical efficiency. Every work setting has expectations for productivity and incentives for employees. In this particular case, Mr. Allen and the employer should have discussed the company's policy and incentive program regarding the sale of hearing aids prior to an employment agreement. Setting standards or quotas is not inappropriate in business and is not inherently unethical in clinical practice. It is our responsibility as clinicians to know what is right and wrong when we are discussing products with our patients. This same clinical ethic should be applied to our business practices. Is the patient receiving what he/she needs? Is the outcome appropriate for the client? We as clinicians must recognize that we are in business, if we are to survive into the next the millenium.

Case Study

Responses

• Charles Anderson
• David Hawkins

Annotated Bibliograhy