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.
Physicians working in close-knit communities, whether small towns or urban neighborhoods, have to manage relationships with people who may be simultaneously patients and neighbors, friends, and business associates.
Physician employment adds a practice management stakeholder to the patient-physician encounter, a stakeholder whose financial interests differ from those of physicians in solo or group practice.
When deciding whether to offer deep brain stimulation earlier than usual for Parkinson disease, it is important to consider not only the patient’s autonomy but also the validity of the evidence and concepts of harm that are being used to form practice policies.