In the "Ethics year in review" session this afternoon, Daniel P. Sulmasy, FACP, and attendees debated the moral and practical merits of paying patients to lose weight or quit smoking. The concept dramatically changes the way physicians would go about encouraging healthy practices, he said. "I think it begins to move us along the continuum from persuasion to manipulation." Financial incentives also may be ineffective, according to some research, because of the way they mess with people's motives. For example, patients can be reluctant to engage in healthy behaviors if they're not being paid, or suspicious of their physicians' motivations for providing compensation.
The discussion naturally led to the financial incentives that shape physicians' behavior, from pay for performance to pharma support. And that led to some hot debate on whether meetings like Internal Medicine 2009 should allow any industry funding--an issue that doesn't seem likely to be resolved any time soon.