Biopsy Quotas: Ethical Implications of Financial Incentives and Penalties on Dermatologic Care Providers.

The evolution of healthcare payment models has profoundly influenced clinical practices and physician decision-making. While fee-for-service (FFS) models incentivize procedural volume, systems based on Relative Value Units (RVUs) have introduced standardized metrics to compensate physicians based on care complexity and workload. As corporations increasingly own healthcare, financial incentives such as RVUs and procedural quotas raise ethical concerns. Quotas intended to boost efficiency and profitability may prompt corporate entities to pressure clinicians to meet procedural targets, potentially prioritizing financial performance over patient welfare. Such pressures risk leading to overtreatment and unnecessary procedures, challenging the principles of non-maleficence and beneficence, especially when less invasive or non-invasive alternatives are clinically viable. Ethical frameworks, including the AMA Code of Medical Ethics, emphasize the need for compensation models that align with clinical judgment and support patient-centered care.