Rewarding Ethical Medicine

2013 Virtual Mentor  
Physicians are motivated by many things, including the desire to improve the health and well-being of others and an insatiable curiosity about how the human body works in health and illness. But as much as it may pain us to admit it, more pragmatic considerations often factor into the equation-namely, money. It is human nature to be motivated by rewards-financial and otherwise-and health care reform raises myriad questions about which rewards and incentives motivate physicians effectively. Even
more » ... s effectively. Even more difficult to answer is exactly which behaviors and practices should be rewarded. What constitutes "value" in medical care? What are the constituents of quality in patient care? The July issue of Virtual Mentor examines the ethics of physician incentives and the struggle to reform health care delivery in the U.S. in a way that aligns incentives with the goals of medicine. One example of a reimbursement model that has not produced desired results is the Resource-Based Relative-Value Scale, or RBRVS, which provides incentives for performing procedures but not for face-to-face time with patients. As Allan H. Goroll, MD, writes, the consequences of implementing the RBRVS range from skyrocketing cost of health care to a shortage of primary care physicians. Why blame
doi:10.1001/virtualmentor.2013.15.7.fred1-1307 pmid:23890425 fatcat:4xkts6xc5vdjdpfccszkmi6xgu