Value Judgements

July 5, 2017
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Over the last few years, Johns Hopkins clinicians and researchers have taken the lead nationally to promote high-value care—a movement to improve quality and safety by reducing unnecessary practice while simultaneously reducing costs.

 

In March, Johns Hopkins was one of eight institutions recognized by the Leapfrog Group for its “tireless journey of improvement, with one project after another leading [Hopkins] to even greater achievements in quality and efficiency.” And this October, a team of faculty from more than 80 academic medical centers, led by radiologist Pamela Johnson, will host a national high-value health care conference (see box).

 

It’s against this backdrop that Johns Hopkins medical ethicist Matthew DeCamp and colleague Kevin Riggs have issued a cautionary salvo. In a Viewpoint they wrote for JAMA last December, the ethicists warned that when it comes to medical education, teaching that overemphasizes cost savings could potentially conflict with trainees’ commitment to patient welfare. “If primacy of patient welfare is to truly remain fundamental to the profession,” they wrote, “instilling commitment to this principle should be the most critical ethical value instilled in cultivating professional identity.”

 

For a candid and wide-ranging discussion about the mission of high-value care and the challenges involved in teaching its tenets to today’s doctors-in-training, we brought together DeCamp, an assistant professor in internal medicine who is affiliated with the Berman Institute of Bioethics; Johnson, vice chair of education for radiology; and Roy Ziegelstein, vice dean for education in the school of medicine.

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