In the Dec. 1, 2015 issue of JAMA,  UPenn PRC Director Kevin Volpp, MD, PhD, joins Timothy J. Judson, MD, MPH, University of California/San Francisco, and Allan S. Detsky, MD, PhD, University of Toronto, in discussing the complexities of determing the right mix of physician motivators to achieve the “value goal” in health care.  Noting “in the context of health care, it is generally more difficult to determine quality. Health care comprises both amenities, which can be easily seen, and technical proficiency, which is difficult for a nonexpert to assess,” Volpp and co-authors explore how extrinsic and intrinsic motivators can be effective or ineffective, depending on several factors.