Provider-patient relations and treatment choice in the era of fiscal incentives: the case of the end-stage renal disease program.
Debates about the extent to which patients can and should participate in medical decision making take on new urgency as cost-containment efforts give patients more financial incentives. The Health Care Financing Administration's recent proposal to enable dialysis patients to "price shop" aroused consternation among nephrologists. A working seminar elucidated their fears about professional incomes and about increased patient autonomy.
D014487:Centers for Medicare and Medicaid Services, U.S.; D003363:Cost Control; D004992:Ethics, Medical; D006699:Home Care Services; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000628:therapy; D009313:National Health Programs; D026706:Paternalism; D010358:Patient Participation; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012052:Reimbursement, Incentive; D006435:Renal Dialysis / Q000191:economics*; D040841:Resource Allocation; D014481:United States