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Consumerism Reshaped Doctor-Patient Power
- Medicine's shift to consumerism gave patients more leverage in treatment decisions and increased demand for drugs.
- That change mixed with industry incentives contributed to harmful prescribing trends like opioid overuse.
Pain As A Measured Vital Sign Fueled Prescriptions
- Pain became the "fifth vital sign," making subjective reports central to prescribing decisions.
- That shift pushed physicians toward prescribing opioids despite weak objective measures of pain and benefit.
Satisfaction Scores Create Perverse Incentives
- Tying physician evaluation to patient satisfaction creates perverse incentives to grant requests.
- Doctors may prescribe unnecessary treatments to avoid bad ratings and professional penalties.