Deciding whether to recommend Avastin or Lucentis raises ethical issues. Should the public health consequences of using a far more expensive drug trump what the doctor thinks is best for the individual patient?
Good ethics and good business don’t have to be in conflict. Ophthalmologists shouldn’t resort to requiring their patients to buy contact lenses in-house; instead, they should focus on expanding their skill set and providing personalized service.
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.