A hypothetical clinical case discusses patient demand for advanced diagnostics such as MRIs when physicians do not recommend such tests. Better patient education is the suggested approach.
Mark T. Hughes, MD, MA and Bimal H. Ashar, MD, MBA
Physicians are urged to evaluate an asymptomatic patient's request for CT screening and use the opportunity to educate the patient and determine the course of action that is in the patient's best interest.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.
Presymptomatic genetic testing for neurodegenerative diseases can help patients make effective treatment decisions, but the medical profession needs to ensure that the increasing use of the tests is done responsibly.