New plans call for paying bonuses to surgeons who save lives on the operating table in the UK.
Under plans being drawn up for the NHS (National Health Services), cash reward schemes could be extended to reflect performance against a number of quality indicators.
Critics of the proposals say that surgeons may be deterred from taking on higher-risk patients and from carrying out complex operations.
For the first time, they will receive performance-related pay according to the results they achieve on the operating table, with levels dependent on how well patients recover.
Leading surgeons said that this could deter doctors from taking on higher-risk patients, such as the frail and elderly, and from carrying out complex operations.
Imperial College Healthcare Trust has begun measuring the performance of its doctors and Prof Stephen Smith, the chief executive, said that it intended to use the data on mortality, infection and the cost-effectiveness of its consultant teams, to reward the best-performing doctors.
The pilot scheme will concentrate on rewarding surgeons for the degree of mobility patients enjoy after their operations.
"We have got to ensure we don't create a dangerous precedent, that the surgeons doing the big complex cases aren't discouraged from taking them on," Telegraph quoted a consultant, Justin Vale, who is the programme group director for surgery and cancer, as saying.
Ben Bridgewater, of the Society for Cardiothoracic Surgeons, said that he would be very cautious of using data on a consultant and his team as the basis for bonus payouts.
"Surgeons would be quite anxious about using these measures in this way," he said.