Accountability is a key ingredient of building trust in health care. Someone asked on a list serve this week why it was necessary to have more regulation regarding quality and equity. To them, the regulatory strictures are the problem. But for the many marginalized individuals who are overlooked, misdiagnosed, or worse, such regulations may be the only protection from harm. Incentives must be realigned to value and pay for care that is patient-focused, flexible to real circumstances patients and families face, and equitable. What incentives? Research funding, payment for quality, provider bonus payments, and peer-reviewed publication requirements are certainly early opportunities for change. As I read so many forecasts for 2023, my hope is for courageous change in the flow of money and scientific accolades toward research and practice that is defined by and with patient and family communities in concert with conscientious researchers. |