Incentives and Individual Target Coefficient Pressure in the Healthcare System
The Individual Target Coefficient and complex formulas added to the healthcare system create pressure on physicians and endanger workplace peace.
The Individual Target Coefficient and complex scoring formulas subsequently added to the incentive system implemented by the Ministry of Health create intense pressure on physicians while negatively affecting workplace peace.
White Reform and the Incentive Process
Following actions taken by physicians for working conditions and personal rights, the Ministry of Health implemented the White Reform regulations. Within this scope, the performance system was replaced by an incentive system, and the Individual Target Coefficient was added to this system last month.
Increasing Patient Applications and Interventions
The applied models create pressure on physicians to see more patients and perform more medical interventions. According to data, while the number of applications to physicians was 209 million in 2002, it reached 1 billion 48 million in 2024, with massive increases in surgeries and examinations.
Income Items and Payments Not Reflected in Retirement
The incomes of physicians working in state hospitals consist of salary, fixed additional payments, flat-rate payments, base additional payments, and incentive payments. Payments other than salary are not reflected in retirement, and deductions are made during leave and sick report periods.
Details of the Individual Target Coefficient
With the new application, incentive calculations have become more complex. In addition to the generated score, many factors such as the hospital's income-expense status, quality score, and academic titles are included in the calculation process.
Ignoring the Team Concept
Although the ministry explains the purpose of the application as differentiation based on qualified score generation, this system pits colleagues against a score competition. While the criteria are based on seeing many patients, resident training or scientific production have no equivalent in the system.
Expectations and Demands of Physicians
The implementation procedures include the Z-score method and various linear function formulas. Physicians, instead of being exhausted by formulas, demand a simple payment system that allows them to live a humanly decent life, ensures security, and does not disrupt workplace peace.