Moderator: Margaret L. Schwarze, MD, FACS, Madison, WI
Co-Moderator: Sharmila Dissanaike, MD, FACS, Lubbock, TX

This ethics colloquium will explore the challenges faced by surgeons when financial incentives and constraints influence clinical practice. We will consider how the financing of health care impacts both patients and surgeons, and identify ethical norms and boundaries to guide surgeons through this difficult environment. The session will use case-based problem learning to address: (1) how best to care for patients with significant out of pocket costs; (2) how to respond to financial incentives for productivity while preserving important aspects of surgical care that are not tangibly rewarded; (3) how to allocate resources in the setting of scarcity (organs, intensive care unit [ICU] and tertiary care beds); and (4) what the surgeon’s duty is in addressing socioeconomic factors leading to surgical illness.

Presentations and Speakers

Margaret L. Schwarze, MD, FACS, Madison, WI
Sharmila Dissanaike, MD, FACS, Lubbock, TX

Point and Counterpoint: The Surgeon Should Not Consider the Financial Toxicity of the Patient’s Workup
Scott B. Grant, MD, MBE, New Brunswick, NJ

Point and Counterpoint: The Surgeon Must Consider and Adapt the Workup to Accommodate the Financial Toxicity
Catherine J. Hunter, MD, FACS, Chicago, IL

Mark C. Weissler, MD, FACS, Chapel Hill, NC

Point and Counterpoint: Referring and Accepting Surgeons Should Not Decide Which Patients Should Get Access to Scarce Resources
Allan B. Peetz, MD, FACS, Nashville, TN

Point and Counterpoint: Referring and Accepting Surgeons Should Be Responsible Stewards of Scarce Resources and Not Transfer Patients Who Have Little to Gain from Transfer
Kristy K. Broman, MD, MPH, Nashville, TN

Tyler G. Hughes, MD, FACS, Salina, KS

Point and Counterpoint: Financial Incentives Are Critically Important to Generating Productivity and Keep Physicians Focused on Important Aspects of Clinical Practice While Maintaining Salary Equity within a Group
Krista Haines, DO, Durham, NC

Point and Counterpoint: Volume-Based Incentives Are Harmful to Patient Care and Artificially Reward Surgeons for Procedures That May Not Be So Valuable to Patients
Lesly A. Dossett, MD, MPH, FACS, Ann Arbor, MI

Julie A. Freischlag, MD, FACS, Winston-Salem, NC

Point and Counterpoint: Surgeons Have a Duty to Prevent Surgical Illness and Address Socioeconomic Disparities That Lead to Life-Limiting Traumatic Injury
Tanya L. Zakrison, MD, FACS, FRSCS, MPH, Miami , FL

Point and Counterpoint: These Are the Barriers to Addressing the Needs of Patients Who are Affected by Structural Violence and Inequality 
Carrie A. Sims, MD, PhD, FACS, Philadelphia, PA

L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon),FRCSGlasg(Hon)