Shivan J. Mehta, MD, MBA and David A. Asch, MD, MBA
Outcome-based payment more closely aligns payments with what patients want, which is better health rather than more health care. But these approaches remain challenging to implement.
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.
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.
Amy Barnhorst, MD, Garen Wintemute, MD, MPH, and Marian E. Betz, MD, MPH
When mandatory reporting of risk of violence is not required, physicians should balance patient autonomy and beneficence with patient and public safety.
AMA J Ethics. 2018;20(1):29-35. doi:
10.1001/journalofethics.2018.20.1.ecas1-1801.
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.