A ‘Period of Maladjustment’:

Abstract

Rapid changes in the medical practice environment pose novel ethical challenges for clinicians. As during any time of great innovation, unanticipated conflicts, problems, or ethical questions may arise, creating a “period of maladjustment” between the introduction of the innovation or technological advancement and the point at which society achieves consensus on the appropriate use of that innovation or advancement. This article reports examples of physicians and physician assistants who exercised poor judgment — often in the absence of systems or structural supports — when faced with novel ethical dilemmas involving advancements such as electronic health records, social media, medical marijuana certification, and access to an international marketplace for drugs and devices. It suggests areas for intervention for licensing boards, educators, and other oversight entities that may better equip licensees to address these novel ethical dilemmas. Finally, because the primacy of patient welfare cannot be the responsibility of individual providers alone, this article supports a call to action for organizations to develop structures to support a culture of professionalism dedicated to safeguarding patients, clinicians, and the profession of medicine itself in this new medical environment.