Compensation models in emergency medicine: An ethical perspective - 13/12/19

Doi : 10.1016/j.ajem.2019.158372

Daniel R. Martin, MD, MBA ^a,^{^⁎} , John C. Moskop, PhD ^b , Kelly Bookman, MD ^c , Jesse B. Basford, MD ^d , Joel Martin Geiderman, MD ^e
^a Department of Emergency Medicine, Ohio State University, 760 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210, United States of America
^b Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-0001, United States of America
^c University of Colorado School of Medicine, Department of Emergency Medicine, 12401 E. 17th Ave, B125, Aurora, CO 80045-2548, United States of America
^d Alabama College of Osteopathic Medicine, 445 Health Sciences Blvd, Dothan, AL 36303, United States of America
^e Department of Emergency Medicine, Ruth and Harry Roman Emergency Department, Cedars Sinai Medical Center ED, 8700 Beverly Blvd, Los Angeles, CA 90048-1804, United States of America

^⁎Corresponding author.

Abstract

There is considerable diversity in compensation models in the specialty of Emergency Medicine (EM). We review different compensation models and examine moral consequences possibly associated with the use of various models. The article will consider how different models may promote or undermine health care's quadruple aim of providing quality care, improving population health, reducing health care costs, and improving the work-life balance of health care professionals. It will also assess how different models may promote or undermine the basic bioethical principles of beneficence, non-maleficence, respect for autonomy, and justice.

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Keywords : Relative value units, Quadruple aim, Physician incentives, Principles of bioethics