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Physicians' ethical beliefs about cost-control arrangements.
D P Sulmasy1, M G Bloche, J M Mitchell
1The John J. Conley Department of Ethics, St Vincents Hospital, New York, NY 10011, USA. daniel_sulmasy@nymc.edu
Archives of Internal Medicine
|March 21, 2000
Summary
Most physicians find financial incentives in healthcare ethically problematic, negatively impacting patient trust and loyalty. These cost-control measures raise significant ethical concerns for medical professionals.
Area of Science:
- Medical Ethics
- Health Services Research
- Physician Attitudes
Background:
- Limited understanding of physician perspectives on healthcare financing ethics.
- Growing use of cost-control arrangements in healthcare.
Purpose of the Study:
- To assess physician experiences with the ethical implications of healthcare cost-control measures.
- To investigate how financial incentives affect physician decision-making and ethical viewpoints.
Main Methods:
- Cross-sectional telephone survey of 1,549 physicians.
- Random selection from 75 US metropolitan areas.
- Response rate of 74.0%.
Main Results:
- 17% found financial incentives to limit services ethically acceptable.
- Over 50% believed healthcare system changes negatively impacted patient trust.
- 80.8% felt physician commitment to undivided patient loyalty had diminished.
- Physicians facing incentives to reduce services reported more ethical objections and diminished trust.
Conclusions:
- Most midcareer physicians view common methods influencing medical decisions as ethically objectionable.
- The data indicate significant ethical disquiet among physicians regarding current healthcare arrangements.
- The justification for physician ethical concerns requires further investigation.
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