My most important job is to help my patients (and their families) who are depressed, grieving, or angry following severe injury or illness to imagine possible narratives for the next chapter of life.
AMA J Ethics. 2015;17(6):500-505. doi:
10.1001/journalofethics.2015.17.6.ecas1-1506.
Caregiver trustworthiness and a competent patient’s prerogative to return to suboptimal living conditions are critical considerations in discharge planning.
AMA J Ethics. 2015;17(6):506-510. doi:
10.1001/journalofethics.2015.17.6.ecas2-1506.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
There is evidence that children who are unaware of their life-threatening diagnoses do not experience any less distress and anxiety than those who are told, and in some cases they may actually experience more.
Patients with dementia need social supports and opportunities and acceptance of their disability in order to feel hopeful despite their functional decline.
AMA J Ethics. 2017;19(7):649-655. doi:
10.1001/journalofethics.2017.19.7.ecas2-1707.
Shivan J. Mehta, MD, MBA and David A. Asch, MD, MBA
Outcome-based payment more closely aligns payments with what patients want, which is better health rather than more health care. But these approaches remain challenging to implement.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.