Eh, there's some truth to what you said but it's a bit of a stretch. For bonuses, it depends on specialty and practice. In my current job I have zero incentive structure, period. If by some miracle, zero patients showed up on my shift, I would make exactly the same as if I saw 20 patients. I also don't get any reimbursement for the procedures I do -- 100% of that goes to the hospital. This is an increasingly common compensation model.
As for promotions. Not at all. First, physicians tend to have a very flat hierarchy outside of academics. At may hospitals, you're either CMO, a department chief, or just some guy. So I would estimate that promotion is not even on the something that's on radar for > 90% of physicians. Second, productivity is not a principle criterion for promotion. If a hospital or clinic promotes a physician, they are going to take a large chunk of that physician's clinical time and replace it with administrative work. Your most clinically productive person is precisely the last person you want to do that with.
The balancing act of this is that oversight is (typically) by qualified medical professionals who can judge whether a given procedure, test, surgery, etc. was medically indicated or not.