Laurel J. Lyckholm, MD and Arwa K. Aburizik, MD, MS
Decision-making capacity can be preserved in patients with mental illness and should be formally assessed in the context of their values and past decisions.
AMA J Ethics. 2017;19(5):444-453. doi:
10.1001/journalofethics.2017.19.5.ecas4-1705.
Anne Drapkin Lyerly, MD, MA and Ruth R. Faden, PhD, MPH
Participation in a research study—in which there are rigorous standards and close monitoring—may be a safer context for the use of medications in pregnancy than the clinical setting, where the evidence base is lacking.
Shivan J. Mehta, MD, MBA and David A. Asch, MD, MBA
Outcome-based payment more closely aligns payments with what patients want, which is better health rather than more health care. But these approaches remain challenging to implement.
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.