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Emerging Ethical Issues of Trust
By Render S. Davis; MHA, CHE
Crawford Long Hospital at Emory University
Conflicts of interest are not a new phenomenon in medicine.
In the older fee-for-service system [FFS], physicians controlled access to medical facilities and technology, and they potentially benefited financially with every order, test, procedure, surgery or prescription they wrote.
Temptation to Over-Treat
Consequently, there was an inherent temptation to over-treat patients. Even marginal diagnostic or therapeutic procedures were justified on the grounds of both clinical necessity and legal protection against threats of negligence. And, this temptation remains a viable siren-call today.
Managed Care’s Influence
In managed care, the potential conflicts between patients and physicians take on a completely different dimension.
By design, in health plans where medical care is financed through prepayment arrangements, the physician’s income is enhanced not by doing more for his or her patients, but by doing less. This phenomenon is especially acute with some capitation reimbursement contracts and settings.
Assessment
Today, patients, confronted with the realization that their doctor will be rewarded for the use of fewer resources, might no longer rely with certainty on the motives underlying a physician’s treatment plan.
Conclusion
Of course, as a consequence, it has been said that one inevitable outcome of the above is a decline in doctor-patient trust. And so, is this a real or perceived notion; please opine?
Related Information Sources:
Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Health Administration Terms: www.HealthDictionarySeries.com
Physician Advisors: www.CertifiedMedicalPlanner.com
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