Make sure you know who signs your doctor’s paycheck

You have a persistent cough and poor appetite, but for six months your doctor has prescribed an assortment of antibiotics after an initial chest x-ray showed a small pneumonia. Finally, short of breath, you go to the emergency room where a CT scan reveals untreatable lung cancer. Later you find your doctor has received a bonus from your HMO insurer for not ordering a CT scan earlier. Physicians count on experience to pursue patient symptoms, but does dangling a bonus suppress their learned instinct from medical school and residency training? Ethically, is it also a violation of the Hippocratic Oath to do no harm if the bonus was more important than the patient? Increasingly, employed and contracted doctors face this moral dilemma. Sometimes authorities at a higher level deny procedures, consultations, and treatments. When though the decision falls on your physician, how do you know outside employer influence will not affect the care you receive? All of us have seen the mechanized changes in health care with a “drive-thru” atmosphere devoid of emotions. Not only have statistical goals been mandated, but contracts are dangled with bonuses swaying medical decision-making. Who though would violate a physician oath and go against their moral character? When you have a 6-figure education loan to pay off, a new mortgage, and a young family, having a job is paramount. With over a decade invested toward a worthy career, one cannot easily walk away. There is a doctor shortage but d...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs