It isn't necessary to be the best. What is needed is that patient outcomes get better. Those who are at the wrong end of the curve need to acknowledge that they need to do better and those in charge of the system need to assist them to improve.
Making payment conditional on results is not likely to have the desired effect, especially if the decision to pay or not is not made by the person actually affected. If anything it will simply drive medics away from difficult areas of expertise.
Take the above with the usual scepticism, I'm a software developer after all, not a medic. But it seems to me that you always need to have carrots as well as sticks, or perhaps just carrots.
Making payment conditional on results is not likely to have the desired effect, especially if the decision to pay or not is not made by the person actually affected. If anything it will simply drive medics away from difficult areas of expertise.
Take the above with the usual scepticism, I'm a software developer after all, not a medic. But it seems to me that you always need to have carrots as well as sticks, or perhaps just carrots.