How should we pay doctors: a systematic review of salary payments and their effect on doctor behaviour

CRD COMMENTARY:

This appeared to be a reasonable review of the topic area, although the report lacked detail of a number of methodological issues that may affect the validity of the findings. A reasonable search of the literature was performed, using electronic databases and a supplemental search of the bibliographies of retrieved studies. No language restrictions were applied. However, no specific attempts were made to locate unpublished data and so the possibility of publication bias exists. Two reviewers independently assessed the studies for inclusion and extracted the data. However, the studies do not appear to have been systematically assessed in terms of their validity. The study details were tabulated, but the number of participants involved in the studies was not always apparent.
Certain issues surrounding the heterogeneity of the studies were discussed briefly; the use of a narrative presentation was appropriate given the apparent differences between the studies.
The authors findings would appear to follow from the data presented, and a number of limitations and issues surrounding the review were discussed. In view of these comments, the authors' conclusions would appear to be reasonable, but should be considered with some degree of caution.