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?
If a patient’s feelings become sources of resistance to treatment, clinicians need to know how to address these feelings’ influence on the therapeutic capacity of patient-clinician relationships.
AMA J Ethics. 2017; 19(5):436-443. doi:
10.1001/journalofethics.2017.19.5.ecas3-1705.
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.
Is this a conflict over a team member’s practice style or is it a breach professional boundaries? Is it appropriate for team members to make this judgment, or should it instead come from the team leader?
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.
Physicians working in close-knit communities, whether small towns or urban neighborhoods, have to manage relationships with people who may be simultaneously patients and neighbors, friends, and business associates.
Many patients in settings where residents operate can only afford to seek care in a public hospital. The hospital, faculty, and resident surgeon must find ways to minimize the risk to those patients.
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.