Dr Emma Cooke joins Ethics Talk to discuss her article, coauthored with Dr Holland Kaplan: “How Should Technology-Dependent Patients’ Care Be Managed Collaboratively to Avoid Turfing?”
Constraints on hospitalists and surgeons and restricted orthopedic admission criteria can exacerbate patients’ distress that comes from clinicians’ disagreements.
AMA J Ethics. 2023;25(12):E873-877. doi:
10.1001/amajethics.2023.873.
The objective is to compare the costs of providing the same level of quality. When resource-use and quality measures are juxtaposed, the resources used to provide the same level of quality can be compared.
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.
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.