Be upfront with patients about payment incentives
Be upfront with patients about payment incentives
It’s a physician’s duty to be forthcoming
The legal and ethical debate about the role financial incentives play in the delivery of medical care — and a patient’s right to know the details — has become increasingly heated in health care circles.
Your best bet is to be forthcoming, says Kent J. Moore, a reimbursement expert with the Ameri can Academy of Family Physicians in Leawood, KS. "You should be prepared to discuss with patients any financial arrangements that could impact their care. Physicians have a fiduciary responsibility to their patients — one that isn’t met by remaining silent until asked," he says.
Patients’ rights to informed consent and self-determination hold that you should provide any information that is "material" for them to make informed decisions about their health care, he adds. In that respect, incentives attractive enough to influence the way a physician cares for a patient can reasonably be considered material.
Failure to disclose financial details also can carry serious penalties if, for example, a denial of care leads to an unfavorable outcome and then to litigation. Although a malpractice plaintiff ordinarily bears the burden of proving a physician breached his or her duty of care, that burden is reversed if the physician is a fiduciary who did not disclose a conflict of interest, says Moore.
Other compelling reasons exist for disclosing financial information to your patients, he argues. First, describing your incentives in plain English can serve as a moral compass. In other words, if something sounds bad or unfair when you try to explain it, then it probably is, he notes.
Second, most patients already are aware that physicians receive financial incentives. "Failure or refusal to disclose financial incentives to your patients is tantamount to ignoring the proverbial elephant in the middle of the living room or, in this case, the exam room," he points out.
He also notes that the courts and state legislatures are pushing for more disclosure of physicians’ financial arrangements. About 20 states have passed such legislation.
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