Paying for performance in the United States and abroad.

The British sometimes have been characterized as steadfast, measured, tolerant of bus queues and surgical waiting lists, and perhaps even a bit stodgy. Parts of this portrait may be accurate, but the British adoption of pay for performance should dispel the last of these stereotypes forever. In this issue of the Journal, Doran et al.1 describe the initial operation and effect of a British policy (adopted in April 2004) that bases a substantial portion of salary payments to general practitioners on their success in meeting 146 criteria for high-quality performance, each of which is tied to a variable number of . . .