For millennia, physicians enacted their professional mandate to “put the best interest of the patient foremost” by doing everything possible for that patient. Within the past few decades, however, we have learned that doing everything possible is not always in the patient’s best interest. Moreover, the medical profession has come to recognize that physicians have an ethical obligation to be prudent stewards of health care resources. In other words, we simply cannot afford to do everything for every single patient. Therefore, how physicians deliver high-value care that achieves good patient outcomes at reasonable cost, while upholding the primacy of the patient-physician relationship, can prove challenging. Contributors to the November 2015 AMA Journal of Ethics help us think through clinical tensions and ethical dilemmas that surface as physicians endeavor to practice high-value care.
Countering the prevailing thought that more medical testing and treatment is always better can be achieved by creating a forum for open discussion of costs and value to prevent patient harm from overuse.
AMA J Ethics. 2015;17(11):1079-1081. doi: