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April 04, 2005

Unethical business practices in health care

At Health Care Renewal Dr. Roy M. Poses discusses a recent survey conducted by the American College of Physician Executives (ACPE):

Weber D. Unethical business practices in U.S. healthcare alarm physician leaders. Physician Exec. 2005; March/April. (.pdf)

The ACPE is an AMA-recognized professional organization representing physicians in medical management:

Practitioners in this field are physician executives. A physician executive is first a physician - one who has mastered the science and art of medicine. Physician executives are found in every sector of health care. They may be CEOs or Department Chairs. They may be entrepreneurs or in government service. They may be in hospitals or group practices or in industrial corporations or consulting firms.

Key findings:

  • A majority of respondents are "very concerned" (56.4%) or "moderately concerned" (35.6%) about "unethical business practices affecting US health care today."
  • 33.1% agree that at least one physician within their own organization is engaged in unethical business practices
  • 53.8% believe that another health care institution in their community is conducting its business unethically
  • 36% are "very concerned" and 40% are "somewhat concerned" about the influence of pharmaceutical companies on prescribing patterns
  • 59% are "very concerned" about physicians refusing to accept call on patients who don't have insurance
  • 80.8% agree that "professional organizations need to promote tougher ethical standards," but only 24.7% support government interventions to combat ethics violations

Full results of the survey are tabulated here.

I hope this study will serve as a catalyst for discussion and an impetus for future research. It is difficult to generalize from these findings because only 21% of the members completed the survey. Furthermore, the results may overestimate the level of concern among physician executives if those who are most concerned about ethics are disproportionately likely to fill out a survey on the topic.

However, as Dr. Poses notes, "If physician executives are this worried, it suggests that doctors in the trenches may be even more so."

Thanks to Revere for the tip.


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An off-topic comment:

I went to the eye doctor today. My co-pay was $10. I got new glasses worth $200 of which I have to pay $32. As I walked home it occurred to me that the easiest way to control health costs would be high co-pays, but no one seems to like them - customers don't like them because they want to be really insulated from their health care costs, and health insurers apparently don't like them because there is more profit in having people pay high monthly flat rates than in having them pay lower flat rates and higher co-pays.

Still, right now I've got great insurance (after 15 years with no insurance) and cost is simply no limit on the health services I might consume over the next year.

Deiling health care business with unethical views....Pathethic..!!!

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