Can we measure physician performance?

Can we measure individual physician performance? Social scientists have known for quite some time that performance evaluation can actually depress motivation. SO the question can actually become, not can we, but should we?  Cassell and Jain, in an interesting JAMA viewpoint paper [JAMA, June 27, 2012—Vol 307, No. 24] tackle the issue directly and present many compelling arguments as to why individual performance systems are likely to decrease intrinsic motivation and increase extrinsic motivation. The authors argue for more meaningful patient-centered goals that are clearly communicated. Ultimately, the authors recommend for more group/team based incentives. In my opinion, they are talking sense, and the paper is worth a read. Their paper is an interesting counter point to the idea of physicians as homo-economicus.