By
ROBERT PEAR
The New York
Times
Published:
December 26, 2012
With
hospitals buying up medical practices around the country and seeking to make
the most of their investment, the American Medical
Association reached out to doctors this week to remind them that patient
welfare must always come first and not be overridden by the economic interests
of hospitals that now employ doctors in ever-growing numbers.
“In
any situation where the economic or other interests of the employer are in
conflict with patient welfare, patient welfare must take priority,” says a
policy statement adopted by the association.
“A
physician’s paramount responsibility is to his or her patients,” the
association said. At the same time, it added, a doctor “owes a duty of loyalty
to his or her employer,” and “this divided loyalty can create conflicts of
interest, such as financial incentives to over- or under-treat patients.”
The
association is disseminating its policy to doctors at a time when more of them
are becoming hospital employees. About one-third of new doctors say they would
prefer to be employed by hospitals, rather than practice on their own. The
association is urging hospitals and medical groups to adopt similar policies.
A
major goal of the guidelines is to protect the professional autonomy of
doctors. Hospital employment agreements often include provisions that
discourage doctors from sending patients to providers of services that are not
affiliated with the hospital.
The
guidelines say that “physicians should always make treatment and referral
decisions based on the best interests of their patients.” Moreover, the
association says, patients should be told whenever a hospital provides
financial incentives that encourage, discourage or restrict referrals or
treatment options.
