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.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.
The graphic novel Swallow Me Whole highlights the need for patient-centered care that engages not only patients but also extended family and the community.
AMA J Ethics. 2018;20(2):148-153. doi:
10.1001/journalofethics.2018.20.2.ecas3-1802.
In the same way that we learn about normal variations in blood pressure, we need to learn about “normal” variations in sexual interests and practices. We want to avoid clueless questions or unintentionally inflammatory statements.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.
Although measures of patient satisfaction are being used to improve patients’ hospital experience, implementing incentives based on these measures may be premature and have unintended consequences for care delivery.
AMA J Ethics. 2015;17(7):616-621. doi:
10.1001/journalofethics.2015.17.7.ecas3-1507.