Dr Matthew C. Bobel joins Ethics Talk to discuss his article, coauthored with Dr Robert K. Cleary: “How Should Risk Be Communicated to Patients When Developing Resident Surgeon Robotic Skills?”
Medicine is a service industry, the product of which is health care, and its practitioners deserve remuneration. But to some, the notion of medicine as a road to personal wealth is an example of free-market economics gone awry.
AMA J Ethics. 2015;17(8):780-786. doi:
10.1001/journalofethics.2015.17.8.msoc1-1508.
Michael Farias, MD, MS, MBA and Rahul H. Rathod, MD
A distinguishing feature of a SCAMP is its ability to capture knowledge-based diversions from a recommended pathway and to “learn” from such individualized patient management.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
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.
The physician must consider the potential benefits of the new procedure and then determine, through discussion with the patient, what value the patient places on those specific benefits.