The social-justice question we must pose to physicians is: Are you willing to advocate for changes to the medical system that creates the need for you to take on charity care in the first place?
Laurel J. Lyckholm, MD and Arwa K. Aburizik, MD, MS
Decision-making capacity can be preserved in patients with mental illness and should be formally assessed in the context of their values and past decisions.
AMA J Ethics. 2017;19(5):444-453. doi:
10.1001/journalofethics.2017.19.5.ecas4-1705.
There is evidence that children who are unaware of their life-threatening diagnoses do not experience any less distress and anxiety than those who are told, and in some cases they may actually experience more.
Patients with dementia need social supports and opportunities and acceptance of their disability in order to feel hopeful despite their functional decline.
AMA J Ethics. 2017;19(7):649-655. doi:
10.1001/journalofethics.2017.19.7.ecas2-1707.
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.