Conflicts of interest. Physician ownership of medical facilities. Council on Ethical and Judicial Affairs, American Medical Association

In this report, the Council on Ethical and Judicial Affairs revisits the question of referral of patients to medical facilities in which physicians have financial interests ("self-referral"). The Council issued safeguards in 1986 to prevent abuses of self-referral and most recently updated the guidelines in 1989. Recent studies, however, have suggested that problems with self-referral persist; these problems undermine the commitment of physicians to professionalism. The Council has concluded that, in general, physicians should not refer patients to a health care facility outside their office practice at which they do not directly provide care or services when they have an investment interest in the facility. Physicians may invest in and refer to an outside facility if there is a demonstrated need in the community for the facility and alternative financing is not available.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Ethics Manual: Fifth Edition
Snyder et al.
ANN INTERN MED 2005;142:560-582.
ABSTRACT | FULL TEXT  

Leasing Imaging Facilities to Referring Physicians: Fee Shifting or Fee Splitting?
Berlin and Berlin
Radiology 2005;234:44-48.
FULL TEXT  

Unregulated private markets for health care in Canada? Rules of professional misconduct, physician kickbacks and physician self-referral
Choudhry et al.
CMAJ 2004;170:1115-1118.
FULL TEXT  

Self-referred Whole-Body CT Imaging: Current Implications for Health Care Consumers
Illes et al.
Radiology 2003;228:346-351.
ABSTRACT | FULL TEXT  

Managing Conflicts of Interest in the Conduct of Clinical Trials
Morin et al.
JAMA 2002;287:78-84.
ABSTRACT | FULL TEXT  

American College of Cardiology/Society for Cardiac Angiography and Interventions Clinical Expert Consensus Document on Cardiac Catheterization Laboratory Standards: A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents endorsed by the American Heart Association and the Diagnostic and Interventional Catheterization Committee of the Council on Clinical Cardiology of the AHA
Bashore et al.
J Am Coll Cardiol 2001;37:2170-2214.
FULL TEXT  

Disclosing Physician Financial Incentives
Miller and Sage
JAMA 1999;281:1424-1430.
ABSTRACT | FULL TEXT  

Sale of Non-Health-Related Goods From Physicians' Offices
Council on Ethical and Judicial Affairs, American
JAMA 1998;280:563-563.
FULL TEXT  

Protecting Patient Welfare in Managed Care: Six Safeguards
Emanuel and Goldman
Journal of Health Politics, Policy and Law 1998;23:635-659.
ABSTRACT  

Preserving Community in Health Care
Emanuel and Emanuel
Journal of Health Politics, Policy and Law 1997;22:147-184.
ABSTRACT  

Institutional Conflict of Interest
Emanuel and Steiner
NEJM 1995;332:262-268.
FULL TEXT  

Understanding Financial Conflicts of Interest
Thompson
NEJM 1993;329:573-576.
FULL TEXT