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Bedside Manna Deborah Stone Oberlander p. 95 Historically, when it came down to treating patients, doctors ultimately did what was best for the patient. Now there is an increase of profit-driven medical decision making. Growth of health insurance in theory eliminates patients’ ability to pay as a factor in treatment, but in reality medicine is like a business (1957: AMA’s Principles of Medical Ethics forbids doctors to “‘dispose of his services under terms or conditions that tend to interfere with or impair the free and complete exercise of his medical judgment or skill.’”) problem: never acknowledged that fee-for-service payment might interfere with medical judgment. 1960s: Increase in doctors’ care, some scandals with medical incentive schemes (e.g. drug and device companies) 1970s-1980s: cost control measures resisted by doctors, no solution, increase in number of uninsured USA relies on influencing doctors with financial punishment or reward to contain costs:
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  • Spring '08
  • Physician, Doctor-patient relationship, Ethics forbids doctors

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