At What Price Physician Autonomy?

From the New York Times “Today’s Economist” Blog:

After a lengthy discourse on health policy with a physician, I asked him to describe the ideal health system from a physician’s perspective. “Everyone in society should have access to needed health care,” he responded. “Only the physician and the patient should decide how to respond to a given medical condition. And someone should reimburse providers of health care at reasonable rates.”

Leave aside the fact that providers of health care are “paid” for their services, not “reimbursed,” the latter method always breeding bad managerial habits. Leave aside also that the definition of “needed” health care is highly elastic. Focus instead on the core of the ideal: complete clinical autonomy for physicians and their patients to throw whatever resources they wish at given medical conditions, usually at someone else’s expense, with little or no accountability for their preferred treatments’ quality or success.

Most physicians, and I would suspect most of their patients, probably subscribe to this ideal. Alas, a mounting body of research leads experts to doubt that physician autonomy actually serves society well and that it will be affordable much longer.

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