Doran T - Pay-for-performance schemes share the common approach of offering financial incentives to healthcare providers for achieving specified performance targets. However, even the most successful schemes carry the risk of unintended effects, such as loss of professionalism, neglect of unincentivized activities, and fraudulent behavior. These risks need to be weighed against the potential benefits of financial incentives, and, in any future pay-for-performance schemes, should be mitigated during development and carefully monitored during implementation.