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.
Global health training offered through UCSF’s EMPOWUR program prepares ob/gyn residents to work in under-resourced communities locally as well as globally.
AMA J Ethics. 2018;20(3):253-260. doi:
10.1001/journalofethics.2018.20.3.medu1-1803.
There are at least two considerations here: the patient’s perception of a physician’s empathic expression and the physician’s level of comfort with expressing empathy and attending to patients’ emotions.
AMA J Ethics. 2015;17(2):111-115. doi:
10.1001/virtualmentor.2015.17.2.ecas1-1502.
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 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.