Guidelines for proceeding with a plan of care when family members have conflicting opinions about the patient’s wishes and the patient does not speak the same language as her physicians.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
The organ transplantation system is viewed as one of our most equitable health care services, but poor patients are effectively excluded by policy that denies Medicaid coverage of post-transplant immunosuppressant medication.
Physicians should recognize that patients’ beliefs may cause them to have non-medical explanations for their illnesses and that shared explanations should be negotiated if treatment plans are to be successful.