The Ontario government has come up with a new idea in terms of hospital management. Chief executive officers at Ontario hospitals will soon see their salaries tied to performance targets that are supposed to result in better outcomes for patients. The government says it will make health-care providers and executives accountable for improving patient care. The government says it will move to what it calls a patient-based payments system of hospital funding, based on the types and volumes of patients hospitals treat. There will also be new initiatives to reduce avoidable hospital admissions and re-admissions and the unnecessary use of diagnostic equipment. It sounds good but what happens if the pressure is put on medical staff to get patients out of the hospital faster than they do now because the CEO’s salary is on the line? Will it mean that sick people will be sent home sooner than they should be? And will it mean that physicians will be expected to reduce the number of tests they order to accommodate the CEO’s personal drive for more money? As we’ve seen with Eastern Health recently, there are serious management issues that go right to the top. Such a system here might only accentuate the lack of depth at the top levels of Eastern Health, including the CEO Vicki Kaminski. Here’s hoping that if such a system were introduced here, none of us would be forced out of the hospital so as to ensure the CEO got a bonus.