Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.
Abraar Karan, MD, Daniel DeUgarte, MD, and Michele Barry, MD
Responsibility for physician “brain drain” can be attributed to the resource-poor countries that lose talent, the wealthy recruiting countries, and individuals.
AMA J Ethics. 2016;18(7):665-675. doi:
10.1001/journalofethics.2016.18.7.ecas1-1607.
Dr Rajesh R. Tampi joins Ethics Talk to discuss his article, coauthored with Drs Aarti Gupta and Iqbal Ahmed: “Why Does the US Overly Rely on International Medical Graduates in Its Geriatric Psychiatric Workforce?”
Web-based physician rating sites are part of a multi-decade cultural shift in the relationship between physicians, patients, and society. But a system in which “patient’s orders” reign is just as lopsided as one that puts “doctor’s orders” in the driver’s seat.
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.