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.
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 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.
Many team members such as nurses and medical assistants have key roles in meeting practice goals but receive little if any performance-based compensation. In part, nursing union rules create a barrier by inhibiting trials of productivity-based pay or shared-risk models.
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.
Physicians who torture historically have not been held accountable by the law or medical profession, but national medical associations can promote accountability.
AMA J Ethics. 2015;17(10):945-951. doi:
10.1001/journalofethics.2015.17.10.pfor1-1510.