Ethics, Professionalism, and Health Policy
Ethical practice
Candidates must understand informed consent, shared decision-making, and conflict-of-interest management. Know the principles of beneficence, nonmaleficence, autonomy, and justice as applied to surgical decisions. Recognize the ethical duty to recommend the appropriate treatment even when it is less remunerative.
Professionalism and policy
Understand scope of practice, credentialing, and the role of specialty societies. Know health policy concepts relevant to Mohs: access, reimbursement, and prior authorization. Recognize the importance of peer review and continuous quality improvement.
Traps
A frequent trap is a scenario where financial incentive conflicts with appropriate care - the ethical answer favors patient welfare. Another is assuming a procedure is appropriate simply because it is reimbursed. Know that informed consent requires discussion of alternatives, including no treatment.
Worked example
A patient requests Mohs for a small, low-risk BCC on the back because of insurance coverage. The ethical response is to explain that excision or other options may be equally effective and to recommend based on tumor biology, not reimbursement. The rule: patient welfare overrides financial or convenience considerations.