Physicians’ Responses to Resource Constraints

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Abstract
The ceaseless rise of health care costs is driving concerns about the best way to contain expenditure. Inevitably, cost containment efforts require changes in physician practices.1-3 The role that physicians should play in the allocation of resources is a matter of debate. On the one hand, it has been argued that cost should never enter into physicians’ decision making at the bedside.4-7 On the other hand, it has also been pointed out that their responsibility toward society requires physicians to become stewards of scarce resources.3,8,9 This debate reflects what is, in effect, a deep role conflict that physicians face when they are in a situation where they must allocate resources in clinical practice.10 Thus, a key question is how do physicians confront and resolve the ethical challenges posed by resource constraints and cost containment efforts?