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.
Is this a conflict over a team member’s practice style or is it a breach professional boundaries? Is it appropriate for team members to make this judgment, or should it instead come from the team leader?
Physician employment adds a practice management stakeholder to the patient-physician encounter, a stakeholder whose financial interests differ from those of physicians in solo or group practice.
If a medical decision about high-value care involves a conflict between the principles of beneficence and justice, an explicit analysis of the individual case is necessary to ensure that the interests of both the patient and society are served.
AMA J Ethics. 2015;17(11):1022-1027. doi:
10.1001/journalofethics.2015.17.11.ecas1-1511.
Meera Balasubramaniam, MD, MPH and Yesne Alici, MD
A 15-year-old advance directive made when the patient was in much better health and not updated can bring more confusion than clarity to the decision-making process.
A 15-year-old advance directive made when the patient was in much better health and not updated can bring more confusion than clarity to the decision-making process.