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.
Although measures of patient satisfaction are being used to improve patients’ hospital experience, implementing incentives based on these measures may be premature and have unintended consequences for care delivery.
AMA J Ethics. 2015;17(7):616-621. doi:
10.1001/journalofethics.2015.17.7.ecas3-1507.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.
The Sustainable Growth Rate was replaced in 2015 by the Medicare Access and CHIP Reauthorization Act, which introduced fixed annual physician fee updates and a merit-based incentive payment system.
AMA J Ethics. 2015;17(11):1053-1058. doi:
10.1001/journalofethics.2015.17.11.pfor1-1511.
AMA Journal of Ethics theme editor Amanda Xi, MD, a transitional year resident at Henry Ford Hospital, interviewed Donald M. Berwick, MD, shortly before the Supreme Court’s decision in King versus Burwell.