A judicious approach to autism would be to replace a “disability” or “illness” paradigm with a “diversity” perspective that takes into account both strengths and weaknesses and the idea that variation can be positive in and of itself.
AMA J Ethics. 2015;17(4):348-352. doi:
10.1001/journalofethics.2015.17.4.msoc1-1504.
In treating children with autism, physicians should reframe the common dynamic in which the family wants medication that the doctor is withholding to focus instead on the family’s and physician’s share goal—the patient’s well-being.
AMA J Ethics. 2015;17(4):299-304. doi:
10.1001/journalofethics.2015.17.4.ecas1-1504.
The objective is to compare the costs of providing the same level of quality. When resource-use and quality measures are juxtaposed, the resources used to provide the same level of quality can be compared.
The neurodiversity movement challenges us to rethink autism through the lens of human diversity, valuing diversity in neurobiologic development as we would value it in gender, race, ethnicity, religion, or sexual orientation.
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.