Medical stewardship is a way of describing a relatively new obligation to maximize health care resources. A professionwide conversation about its meaning and value is needed.
Physicians have a responsibility to assess elderly patients for conditions that could affect their ability to drive safely and to be familiar with state laws that govern physician duty to report impaired drivers.
The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Physicians have a professional obligation and, in many states, a legal duty to report drivers whose functional or cognitive impairments may pose a safety hazard.
State laws often require physicians to report suspected abuse and assault, creating a dilemma for physicians who must not only treat the injured patient but act as an informant to police.
Physicians should seriously weigh the benefits and risks involved prior to discussing the possibility of genetic testing with a patient or referring them to a genetic counselor.