New ACP Ethics Paper: Patient Welfare Comes First in Quality and Cost Control Efforts
A new ethics paper, developed by the ACP Committee on Ethics, Professionalism and Human Rights and released in the December 4th issue of Annals of Internal Medicine, highlights the need for increased sensitivity toward patient care in pay-for-performance (P4P) programs. “Pay-for-Performance Principles That Promote Patient-Centered Care: An Ethics Manifesto,” states that pay-for-performance has the potential to help improve the quality of care, if it can be aligned with the goals of medical professionalism.
Pay-for-performance programs appear to be a part of the future of medicine, and as medical students, it is important to be aware of the potential impact these programs could have on patient care, patient-physician relationships, organized medicine, and internal medicine in particular. Initiatives that provide incentives for a few specific elements of a single disease or condition, however, may neglect the complexity of care for the whole patient, especially the elderly patient with multiple chronic conditions. The authors point to the need to adhere to patients’ welfare, preferences, and best interests first and foremost in the effort to improve quality and control costs. Elderly patients and those with chronic conditions are particularly vulnerable to P4P programs they say, as well as patients who might be dropped because of their inability to meet existing measures or who are unable to comply with treatment plans.
By releasing the paper, ACP hopes to move the pay-for-performance debate forward with a patient centered focus—one that puts the needs and interests of the patient first.
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