As one of many urban areas undergoing progressive changes to healthcare reimbursement structures, health systems in New York City have developed a new pay scheme to take effect over the next three years that calculates doctors’ salaries based on how well they reduce costs, increase patient satisfaction, and improve the quality of care. Previously, doctors had been paid annual increases based on cost-of-living expenses, along with bonuses that were proportionate to the amount of services they provided (NY Times, 2013). This effort has extended to professionals at the City’s two primary medical schools – New York University School of Medicine and Icahn School of Medicine at Mount Sinai, as well as the Physician Affiliate Group of New York. Those opposed to the plan claim that facility and resource limitations will make it difficult for doctors to achieve performance goals set forth by the system. Nonetheless, advocates claim that the initiative aligns with national reforms to healthcare policies.