Chromosomal microarray analysis reveals many gene variants of unknown significance. The uncertainty about these variants—might they be deleterious or are they benign?—complicates genetic counseling.
As physicians we decide which tests or treatments go on the bill but have little idea how our decisions impact what patients pay. Now patients, payers, and policymakers are demanding that we consider the cost of our recommendations.
Ruth M. Farrell, MD, MA, Holly Pederson, MD, and Shilpa Padia, MD
Though they claim to, direct-to-consumer genetic tests may not correctly identify an individual's ancestral background, and thus may overstate or understate one's risk for heritable disease.
This month, AMA Journal of Ethics editor-in-chief Audiey Kao, MD, PhD, interviewed Wendy Levinson, MD, about the efforts of the Choosing Wisely initiative to foster cultural change in medicine cross-nationally by stimulating dialogue about overuse of tests and treatments
Although not everything on the Choosing Wisely lists is likely to reduce low-value care, it is a good starting point for a conversation about curtailing low-value interventions.
David S. Gierada, MD and Lawrence M. Kotner, Jr., MD
Despite strong supportive evidence on and professional society endorsement of CT screening for lung cancer, there is minimal demand from patients or physicians.
Believing that unnecessary use of resources is a significant contributor to rising health care costs, the ABIM Foundation launched the Choosing Wisely campaign, in which physicians and patients work together to develop treatment plans that are effective for the patient but are also efficient and promote the sustainable use of limited resources.
Comparative effectiveness research (CER) may become an important factor in Medicare coverage decisions, and the new health care law may make it more easily available to the public to help in medical decision making.
The AMA Code of Medical Ethics' opinions on confidential care for sexually active minors and physicians' exercise of conscience in refusal of services.