The social-justice question we must pose to physicians is: Are you willing to advocate for changes to the medical system that creates the need for you to take on charity care in the first place?
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.
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.
Physician-journalists balance the ethical requirements of two professions with competing goals. Physicians must “do patients no harm ” and “keep secret” what they “see or hear”; journalists seek out and disseminate information in service of public enlightenment.
Amy Barnhorst, MD, Garen Wintemute, MD, MPH, and Marian E. Betz, MD, MPH
When mandatory reporting of risk of violence is not required, physicians should balance patient autonomy and beneficence with patient and public safety.
AMA J Ethics. 2018;20(1):29-35. doi:
10.1001/journalofethics.2018.20.1.ecas1-1801.