Truth or Consequences

作者: Norman G. Levinsky

DOI: 10.1056/NEJM199803263381313

关键词: Health careCommunity hospitalOrthopedic surgeryPaymentMedicineSurgeryMedical emergencyTruth DisclosureHealth care rationingChief executive officerWithholding TreatmentGeneral Medicine

摘要: Several years ago, I served as a panelist at conference on health care ethics university-affiliated community hospital. The chief of orthopedic surgery asked my opinion proposal made to him by the hospital's executive officer (CEO). CEO explained that hospital was losing money hip-replacement surgery, because payment received from Medicare, which paid for nearly all hip replacements, less than cost. A major component cost price prosthesis. requested surgeons use much expensive prosthesis . . .

参考文章(4)
Howard H. Hiatt, Protecting the Medical Commons: Who Is Responsible? New England Journal of Medicine. ,vol. 293, pp. 235- 241 ,(1975) , 10.1056/NEJM197507312930506
H. Gilbert Welch, Should the Health Care Forest Be Selectively Thinned by Physicians or Clear Cut by Payers? Annals of Internal Medicine. ,vol. 115, pp. 223- 226 ,(1991) , 10.7326/0003-4819-115-3-223
Norman G. Levinsky, The Doctor's Master The New England Journal of Medicine. ,vol. 311, pp. 1573- 1575 ,(1984) , 10.1056/NEJM198412133112412
Mark A Hall, Rationing health care at the bedside. New York University Law Review. ,vol. 69, pp. 693- 780 ,(1994)