title: Challenges to ethics and professionalism facing the contemporary neurologist.
abstract: Challenges to ethics and professionalism that can harm neurologists and their patients include the commercialization of medicine, poorly designed Medicare regulations, conflicts of interest, physician employment by hospitals, faulty measurement of medical quality care, electronic health records, electronic communications with patients, and the demotion of the role of physician beneficence. These threats can lead to inaccurate medical record-keeping, unnecessary medical care, a decline in the primacy of patients' interests, and damage to the sanctity of the patient-physician relationship. The increasing frequency of physician burnout can be attributed at least partially to unmitigated stresses on practicing physicians, particularly the growing time pressures for patient visits, the mounting daily requirements of documentation, and the increasing burden of time-consuming but unproductive tasks. Recommended correctives include reforming billing documentation regulations, improving electronic health records, designing proper quality indicators integrating physician wellness, and incorporating reasonable physician workflows in the design of accountable care organizations.
authors.affiliation: From the Geisel School of Medicine at Dartmouth, Hanover, NH. bernat@dartmouth.edu.
authors.forename: James L
authors.initials: JL
authors.lastname: Bernat
mesh_terms: D002055:Burnout, Professional / Q000523:psychology; D016265:Conflict of Interest; D004282:Documentation; D057286:Electronic Health Records / Q000941:ethics; D004992:Ethics, Medical; D006801:Humans; D006278:Medicare / Q000331:legislation & jurisprudence; D009462:Neurology / Q000191:economics / Q000941:ethics*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000191:economics / Q000331:legislation & jurisprudence / Q000523:psychology*; D014481:United States