Magazine article Medical Economics

The Physician's Paradox: Patient Finances and Caring for the Sick

Magazine article Medical Economics

The Physician's Paradox: Patient Finances and Caring for the Sick

Article excerpt

Physicians are charged with caring for the sick. What, exactly, does that mean? Is it sufficient just to provide accurate medical advice or are physicians responsible for ensuring that patients abide by it? Where finances prevent a patient from receiving needed medical attention, physicians may be tempted to intervene by providing the required funds directly to the patient or by waiving the patient's cost-sharing obligations.

WHILE PHYSICIANS may think helping patients in need is a noble endeavor, they should bear in mind the old adage,"no good deed goes unpunished." Providing such assistance is not without some legal risk.

Undue influence

In New York, for example, it is considered misconduct to exercise undue influence on a patient for the financial gain of the physician or a third party.

This prohibition specifically includes "the promotion of the sale of services, goods, appliances, or drugs" by the physician. Physicians who give patients money to pay for prescription drugs, medical procedures or insurance premiums may violate this law where the specific goods or services are unattainable absent the physician's intervention.

Providing such funds could be considered an exercise of undue influence resulting in the purchase of goods or services by the patient which financially benefits a third party, or possibly the physician, should the patient return for additional treatment.

Referral payments

Both the federal antikickback law and the federal civil monetary penalties law prohibit healthcare providers from making payments to induce a referral of business that is paid for by a federal healthcare program. …

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