TY  - JOUR
T1  - PAtient requests for nonbeneficial care—reply
AU  - Brett AS, McCullough LB
Y1  - 2012/05/02
N1  - 10.1001/jama.2012.3611
JO  - JAMA
SP  - 1797
EP  - 1798
VL  - 307
IS  - 17
N2  - 
Dr Laws raises 2 interesting points for consideration. First, to deter patients from making requests for inappropriate clinical management, she proposes that patients should have more financial skin in the game. This proposal has initial appeal for physicians because it would make things easier for physicians in selected cases: Patients would likely make fewer requests for inappropriate tests or treatments. On closer examination, however, there is serious ethical risk. When patients already have co-payments and deductibles that are high enough (and going higher) to dissuade them from seeking unnecessary care, they may also be dissuaded from seeking and implementing necessary medical care. This problem should not be exacerbated. The primary responsibility for managing the inappropriate requests from patients rests with physicians who should respectfully assert their professional integrity. This approach strikes a balance between providing effective medical care, respecting patients' preferences for reasonable interventions, and protecting patients from making bad decisions.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.3611
UR  - http://dx.doi.org/10.1001/jama.2012.3611
ER  -