title: Value-Based Reimbursement: Impact of Curtailing Physician Autonomy in Medical Decision Making.
abstract: OBJECTIVE
  In this article, we define value in the context of reimbursement and explore the effect of shifting reimbursement paradigms on the decision-making autonomy of a women's imaging radiologist.
  
  
  CONCLUSIONS
  The current metrics used for value-based reimbursement such as report turnaround time are surrogate measures that do not measure value directly. The true measure of a physician's value in medicine is accomplishment of better health outcomes, which, in breast imaging, are best achieved with a physician-patient relationship. Complying with evidence-based medicine, which includes data-driven best clinical practices, a physician's clinical expertise, and the patient's values, will improve our science and preserve the art of medicine.
authors.affiliation: 1 Department of Radiology, Northwestern University, Feinberg School of Medicine, Prentice Hospital, 250 E Superior St, Ste 4-2304, Chicago, IL 60611.
authors.forename: Dipti
authors.initials: D
authors.lastname: Gupta
authors.affiliation: 1 Department of Radiology, Northwestern University, Feinberg School of Medicine, Prentice Hospital, 250 E Superior St, Ste 4-2304, Chicago, IL 60611.
authors.forename: Ingolf
authors.initials: I
authors.lastname: Karst
authors.affiliation: 1 Department of Radiology, Northwestern University, Feinberg School of Medicine, Prentice Hospital, 250 E Superior St, Ste 4-2304, Chicago, IL 60611.
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Mendelson
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000191:economics; D010817:Physician-Patient Relations; D017009:Professional Autonomy; D011787:Quality of Health Care / Q000191:economics*; D011871:Radiology / Q000191:economics* / Q000458:organization & administration; D012051:Reimbursement Mechanisms / Q000191:economics*; D062505:Value-Based Purchasing / Q000191:economics*
keywords: breast cancer screening; breast imaging; outcome metrics; physician autonomy; value; value-based reimbursement; women's imaging