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.
Some disability advocates take issue with the “normalization” goals of the medical model of rehabilitation, but expressions of that position can be dismissive of rehabilitationists’ efforts to remediate oppressive functional deficits.
AMA J Ethics. 2015;17(6):562-567. doi:
10.1001/journalofethics.2015.17.6.msoc1-1506.
The Moseley study found no significant difference between those in the arthroscopic lavage and debridement arm of the study and those in the sham surgery arm.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.
Julie M.G. Rogers, PhD, C. Christopher Hook, MD, and Rachel D. Havyer, MD
The medical profession’s valuing of intellectual ability may inadvertently harm people with intellectual or cognitive disabilities who have a different notion of “the good life.”
AMA J Ethics. 2015;17(8):717-726. doi:
10.1001/journalofethics.2015.17.8.peer1-1508.