Dartmouth Atlas Challenges Ethics of 'Doctor-Centric' Care

The latest report from the Dartmouth Atlas Project reveals some troubling ethical quality and safety issues about what investigators are calling a "doctor-centric" medical delivery system for Medicare beneficiaries.

4 comments on "Dartmouth Atlas Challenges Ethics of 'Doctor-Centric' Care"
Susan (3/8/2011 at 2:09 PM)

This report needs to take into consideration cultural aspects of the information. Yes there are more back surgies in Montanna- what do people do for a living in Montanna? Ranchers- heavy lifting. Why would any Doctor recommend surgery over physical therapy if it wasn't necessary? Chances are there are more serious back injuries in Montanna than Souix Falls
Steve Wilkins (3/4/2011 at 6:33 PM)

The report's conclusion that the results reflect a highly "doctor-centered" practice style is consistent with a preponderance of evidence which shows that a "patient-centered" (communications style)is still the exception rather than the rule, at least for primary care. Check out a blog post which addresses this very subject: http://wp.me/pGXmn-1O
Ronald Hirsch, MD (3/4/2011 at 4:23 PM)

Doing things to patients pays, talking to patients does not. Fix the payment system and you'll fix this problem.
ZEN (3/3/2011 at 3:31 PM)

I believe the authors are overeaching with regards to their conclusion about this being "doctor-centric" delivery system. Have they not consider that this may be "patient-centric", and that the disaprities in procedures and care might be secondary to the choices made by the medicare beneficiaries? How can one extrapolate from this data that the physicians are not providing appropriate information or options to their patients. Unless one is intimately involved in the patient/physician conversation, the conclusion of this article is purely a conjecture.


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