Ethics Opinions

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.

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.