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December 6, 2016

Navigating Ethical Tensions in High-Value Care Education

Author Affiliations
  • 1Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
  • 2Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland
  • 3Division of Preventive Medicine, University of Alabama at Birmingham
JAMA. 2016;316(21):2189-2190. doi:10.1001/jama.2016.17488

Enthusiasm for high-value care is increasing throughout health care, including in the education of medical students, residents, and fellows.1 Until recently, there were few examples of educational programs that equipped future physicians with the tools required to practice high-value care or even consider the cost of care they deliver. In fact, future physicians were encouraged to provide care that could be considered as quite the opposite—academia often instilled excess over restraint, celebrating trainees who generated (and tested for) the broadest differential diagnosis. Because physicians who train in high-spending regions subsequently provide more costly care than those who train in low-spending ones,2 medical school and residency are critical times to teach high-value care.

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