Your doctor prescribes some drugs or orders a test when you visit his office; it's no big deal, right? You made an appointment to figure out what's wrong with you and the doctor's trying to do just that.
Most of the time, it's safe to assume your doctor's looking out for your best interests. Period. Unfortunately, it's not always the case.
A conflict of interest happens when someone's involvement in more than one activity or project may lead him to make decisions that favors one while hurting the other. A good example is a lawyer who represents both spouses in a divorce.
Can she really look out for both sides' best interests? Usually not, and that's why most states have ethical rules barring attorneys from doing it.
Recent reports explain how some doctors in California are being paid millions of dollars by big pharmaceutical companies like Pfizer and Eli Lilly. Many of these same doctors are or have been the subject of disciplinary actions in the state.
The whole practice should make you wonder: Is my doctor prescribing a drug because it's made by a company that's paid him thousands of dollars?
According to a 2010 professional report, a larger percentage of doctors across the country have some sort of a relationship with outside companies than ever before. Drug manufacturers are good examples. The trend has increased since 2004.
A new phenomenon is targeted by the new health care reform law. Rather than send their patients (and their insurance dollars to another facility), it's become common for doctors' offices to buy their own equipment for tests like MRIs and CT Scans. Or, the doctors open their own outside testing facility.
The doctors run the tests themselves and collect the fees. It's a practice called self-referrals.
- The doctors in fact own the facility or machines
- The patients can get the test done somewhere else. The doctors must give them a list of other nearby test sites, too
What You Can Do
It's up to you to guard yourself. Whether or not you have a reason to think your doctor is acting in his own best interests instead of yours, when a medication is prescribed or a test is ordered:
- Ask for an explanation of why the drug or test is needed. Ask how often the doctor prescribes or orders it, too. Answers like, "It's just routine," or "All the time," may be an indication that a second opinion is needed
- When it comes to drugs, ask if the doctor is paid in any way by the drug's maker
- If an MRI, CT Scan, or another imaging test is ordered, ask if the doctor has an ownership interest in the testing site. Again, ask how often he orders such tests
- If you suspect a doctor is acting improperly, contact your state's medical board and file a complaint. You may also consider filing a Medicaid/Medicare fraud complaint with the federal government and your attorney general's office
You should feel safe that your doctor is more interested in your health than his wallet. But knowing what to look for and what to do about it may save you and others from unnecessary health risks, not to mention money.
Questions for Your Attorney
- Can I get into legal trouble if I make an honest mistake and file a complaint against my doctor when in fact she didn't do anything wrong?
- Can government agents or law enforcement officials look at my medical records if my doctor is accused of fraud?
- Is there any way I can find out if my doctor's orders of CT Scans has increased since his office purchased its own scanning equipment?