When doctors tell patients what they don't want to hear

In October, 2012, Medicare débuted a new hospital-payment system, known as Value-Based Purchasing, which ties a portion of hospital reimbursement to scores on a host of quality measures; thirty per cent of the hospital's score is based on patient satisfaction. New York City's public hospitals recently decided to follow suit, taking the incentive scheme one step further: physicians' salaries will be directly linked to patients' outcomes, including their satisfaction. Other outpatient practices across the country have also started to base physician pay partly on satisfaction scores, a trend that is expected to grow.