A hospital, located within a highly competitive market, is concerned over a decline in its performance on national quality indicators. Although many members of the medical staff are cooperative and compliant with the required documentation, a group of physicians don’t seem to understand the importance of these measures. When either the hospital administration or members of the medical staff leadership confront these physicians, they often state they will try harder to be compliant, but ultimately don’t change their behavior. Others simply choose to ignore letters sent to them or any attempts to discuss their noncompliance. Frustrated by the lack of cooperation by these physicians, the hospital and medical staff leadership decide to get tough on enforcement. They design a tiered response system. Physicians who do not meet the documentation requirements will be sent a warning letter. Failure to improve or respond will result in temporary loss of privileges. Continued lack of compliance will lead to loss of privileges.

Will this punitive system work to motivate physicians to improve compliance? If not, why not? Develop recommendations as to how to motivate these physicians to improve their compliance.