On June 22, the Center for Studying Heath System Change reported that the net income of doctors dropped 7.7% on average from 1997 through 2003. “‘Flat or declining fees from both public and private payers appear to be a major factor underlying declining real incomes for physicians,'” said HSC Researcher Ha T. Tu, M.P.A, a study coauthor.” Nevertheless, according to the study, medicine remains of one of the best paid U.S. professions (thanks to third party payers). This change may provide impetus for the various pay for performance programs that third party payers are implementing to incent quality and technology improvements.