Using quality oncology practice initiative metrics for physician incentive compensation.

PURPOSE: To demonstrate the use of American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) measures as part of a financial incentive plan for an academic health center-based hematology-oncology division. METHODS: An 11-member QOPI-certified hematology-oncology division participated in a pilot variable compensation (VC) plan with group-specific targets selected based on prior below-average performance. Twenty percent of overall VC was linked to success in two QOPI categories: completion of treatment summaries within 90 days of end of chemotherapy and assessment of patients' emotional well-being by second office visit. Three tiers of achievement were set for each goal. A formula combining VC goals into year-end payout was driven by three levels of percent base salary: 8%, 12%, and 24%, with probability of achievement of each goal of 90%, 50%, and 10%, respectively. Practice leadership was educated about QOPI acceptance in the oncology community. RESULTS: The division participated in QOPI during spring and fall 2012. With systems-based improvements, 40.54% of medical records audited had treatment summaries, resulting in achievement of tier III compensation. Documentation of emotional well-being increased, yielding 63% of patient cases compliant; however, the national benchmark concurrently improved, making this insufficient to achieve tier I. CONCLUSION: QOPI metrics can be used as a quality incentive for oncologists in a VC plan. Non-oncologists can appreciate the strength of QOPI as a quality tool. The combination of a QOPI program through ASCO and use of various QOPI metrics can drive continuous improvement in an oncology group.

An integrated model of gay men's depressive symptoms.

A model of depressive symptoms in gay men is tested that links gender-related personality traits (agency and unmitigated communion) to peer harassment, self-discrepancies in agency, and cold-submissive interpersonal behavior, all of which were reported in previous research to contribute to depression. A sample of 510 gay men was recruited through the Internet. The integrated model was tested using half of the sample and validated with the other half. Significant zero order correlations between the gender-related personality traits and depressive symptoms were mediated by unassured-submissive behavior and self-discrepancies in agency. Recalled peer harassment was linked directly with depressive symptoms and indirectly through unassured-submissive interpersonal behavior.