Pharmacologic interventions might help physicians overcome cognitive deficits resulting from loss of sleep while on call or help them retain more details about the patients under their care.
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.
Volk v DeMeerleer may conflict with professional guidelines regarding physicians’ obligations to breach patient confidentiality to protect third parties.
AMA J Ethics. 2018;20(1):10-18. doi:
10.1001/journalofethics.2018.20.1.peer2-1801.
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.