The advent of force-feeding in the new century in the context of conflict and protest made it necessary to clarify and revise the whole concept of artificial feeding and force-feeding.
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.
Physician-journalists balance the ethical requirements of two professions with competing goals. Physicians must “do patients no harm ” and “keep secret” what they “see or hear”; journalists seek out and disseminate information in service of public enlightenment.
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.