I read with interest Dr. Milne’s recent column on paying patients $100 not to get a CT (January 2020). There is actually robust data in psychology research using money as a quantitative measure for participant motivation. Money crosses cultural barriers and bypasses subconscious biases in a way questionnaires cannot. For example, when we say loss aversion is twice as powerful as motivation to gain, that comes from research where participants would have to be very likely to gain $10 before they would be willing to give up $5. This was landmark research because it is not intuitive—if you had asked these participants to answer it in a survey, they probably would have given the intuitive answer. But money changed the way the participants actually behaved.
The use of money in this study was likely to gauge participant motivation—not to suggest that we should pay people to forgo testing.
Greg Neyman, MD