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 behavior that generates a patient complaint and ultimately leads to disciplinary action is both legally and ethically problematic—violating both regulatory rules and professional codes.
AMA J Ethics. 2015;17(5):448-455. doi:
10.1001/journalofethics.2015.17.5.pfor1-1505.
Jennifer A. Sbicca, MD, Katherine Gordon, MD, and Stefani Takahashi, MD
Match applicants and residency program directors may express their interest in each other, but the cardinal rule of the match is they cannot ask the other how they will be ranked.
The Moseley study found no significant difference between those in the arthroscopic lavage and debridement arm of the study and those in the sham surgery arm.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.
Medical schools’ and hospitals’ Title IX policies should support trainees who have been victimized as well as address known incidents of sexual harassment.
AMA J Ethics. 2018;20(1):3-9. doi:
10.1001/journalofethics.2018.20.1.peer1-1801.