Luckily in most businesses incentives are used by the people designing the incentives to

1) cost as little as possible to the business

2) "optimize" their own pay/career

(There was a study saying that over 80% of sales people would deny their employer a million-dollar contract if it netted them $500 personally, so compared to that this is nothing)

Which makes sure that the incentives are not aligned with the business goals.

Now I guarantee that the best way to destroy intrinsic motivation, bar none, is to provide extrinsic motivation for things that aren't aligned with the business' goals.

I think this is frequently short-sighted. Surgeons are intrinsically motivated to be surgeons and help people, and they are trained to think clinically (pun somewhat intended) about risk-reward. They realize that trying to help high-risk patients will ultimately result in them being able to help fewer patients.