Financing & Delivery of Health Care

Because health care is a fundamental human good, society has an obligation to make access to an adequate level of care available to all its members, regardless of ability to pay.

Physicians have an obligation to be prudent and responsible stewards of health care resources.

Physicians have a responsibility to contribute their expertise to developing resource allocation policies that are fair and that safeguard the welfare of patients.

Physicians individually and collectively have an ethical responsibility to ensure that all persons have access to needed care regardless of their economic means.

Physicians should hold leaders accountable to meeting conditions for professionalism in health care systems. This includes advocating for changes in health care payment and delivery models to promote access to high quality care for all patients, recognizing that over-reliance on financial incentives may undermine physician professionalism.

Under no circumstances may physicians place their own financial interests above the welfare of their patients. Treatment or hospitalization that is willfully excessive or inadequate constitutes unethical practice.

Physicians have an ethical obligation to put the welfare of patients ahead of other considerations, including personal financial interests. This obligation requires them to consider carefully the terms and conditions of contracts to deliver health care services before entering into such contracts, to ensure that those contracts do not create untenable conflicts of interest.

Competition among physicians is ethically justifiable when it is based on such factors as quality of services, skill, experience, conveniences offered to patients, fees, or credit terms.

Physicians have an obligation to inform patients about all appropriate treatment options, the risks and benefits of alternatives, and other information that may be pertinent, including the existence of payment models, financial incentives, formularies, guidelines, or other tools that influence treatment recommendations and care.

Physicians are free to enter into retainer contracts to provide special non-medical services and amenities with individual patients who are willing and able to pay for them. However, physicians must always uphold their primary professional obligation of fidelity and their responsibility to treat all patients with courtesy, to respect patients’ rights and dignity, and to ensure that all patients in their practice receive the same quality of medical care.

Physicians within institutions that have or are contemplating a merger of secular and faith-based institutions have a responsibility to protect the community that the institution serves as well as the integrity of the institution, and other physicians and professionals who practice in association with it, while recognizing that physicians’ primary obligation is to their patients.

Health disparities across patient populations reflect deeply embedded, historically rooted socioeconomic and political dynamics. Physicians and health care institutions have a duty to serve as agents of change to address these structural barriers to optimal health for all.

Physicians should not recommend, provide, or charge for unnecessary medical services; nor should they make intentional misrepresentations to increase the level of payment they receive or to secure non-covered health benefits for their patients.

Physicians have a responsibility to balance patients’ needs and expectations with responsible business practices. With respect to fees for nonclinical or administrative services provided in conjunction with patient care, physicians should clearly notify patients in advance of fees charged by the practice (if any) for nonclinical or administrative services and base fees (if any).

Financial obstacles to medical care can directly affect patients’ well-being and may diminish physicians’ ability to use their knowledge and skills on patients’ behalf. Physicians should not be expected to risk the viability of their practices or compromise quality of care by routinely providing care without compensation. Patients should make reasonable efforts to meet their financial responsibilities or to discuss financial hardships with their physicians.

Payment by or to a physician or health care institution solely for referral of a patient is fee splitting and is unethical.