Medicine, Money, and Morals: Physicians' Conflicts of Interest

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9780195096477: Medicine, Money, and Morals: Physicians' Conflicts of Interest

Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug).
Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct.
Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.

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From the Back Cover :

A theoretically sophisticated, empirically detailed account of conflicts of interest and the physician's role...An impressive piece of work- broad in its scope, clear in its objectives, confident of its finding, certain of the policy implications.

About the Author :


Marc A. Rodwin, Associate Professor of Law and Public Policy at Indiana University, Bloomington, has an M.A. from Oxford University, a J.D. from the University of Virginia Law School, and a Ph.D. from Brandeis University.

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1.

Marc A. Rodwin
Edité par Oxford University Press Inc, United States (1995)
ISBN 10 : 0195096479 ISBN 13 : 9780195096477
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Description du livre Oxford University Press Inc, United States, 1995. Paperback. État : New. Reprint. Language: English . Brand New Book. Physicians conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest; for hospitals to offer incentives to physicians who refer patients to them; or for drug companies to provide lucrative give-aways to entice doctors to use their brand name drugs. In Medicine, Money, and Morals, Marc A. Rodwin examines these conflicts of interest, explains why the profession has failed to cope successfully with them, and shows how they have become worse over the past century. He looks at how - in response to dubious practices of the past such as fee-splitting, physicians ownership of medical facilities, drug dispensing, and the like - the profession developed ethical guidelines but was unable to enforce them. He shows how current public policies and institutional practices now offer doctors financial incentives to promote various goals at odds with the interest of patients. These policies and practices, Rodwin writes, tie doctors personal financial well-being to medical care providers - hospitals, medical suppliers, and pharmaceutical firms - and also to insurers and other third party payers. Doctors today are tempted to think of how they will fare financially by making particular clinical decisions. As a result, patients often receive too many or too few medical services, or the wrong kind, sometimes undergoing painful, dangerous, or unnecessary medical procedures. Rodwin shows what can be learned from the way society has coped with conflicts of interest involving other professionals (lawyers, government officials and financial professionals), all of whom are held to higherstandards of accountability than doctors. He explains, too, why simplistic solutions such as public disclosure of conflicts or government ownership of health services won t work. He offers examples of what can be done to help reduce these problems by regulation, tax policy, audi. N° de réf. du libraire LIB9780195096477

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Rodwin, Marc A.
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ISBN 10 : 0195096479 ISBN 13 : 9780195096477
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Description du livre Oxford University Press 1995-03, 1995. État : New. This item is printed on demand. Brand new book, sourced directly from publisher. Dispatch time is 24-48 hours from our warehouse. Book will be sent in robust, secure packaging to ensure it reaches you securely. N° de réf. du libraire NU-LSI-06850193

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Marc A. Rodwin
Edité par Oxford University Press Inc, United States (1995)
ISBN 10 : 0195096479 ISBN 13 : 9780195096477
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Description du livre Oxford University Press Inc, United States, 1995. Paperback. État : New. Reprint. Language: English . Brand New Book. Physicians conflicts of interest are rampant in the American medical community. Today it is not uncommon for doctors to refer patients to clinics or labs in which they have a financial interest; for hospitals to offer incentives to physicians who refer patients to them; or for drug companies to provide lucrative give-aways to entice doctors to use their brand name drugs. In Medicine, Money, and Morals, Marc A. Rodwin examines these conflicts of interest, explains why the profession has failed to cope successfully with them, and shows how they have become worse over the past century. He looks at how - in response to dubious practices of the past such as fee-splitting, physicians ownership of medical facilities, drug dispensing, and the like - the profession developed ethical guidelines but was unable to enforce them. He shows how current public policies and institutional practices now offer doctors financial incentives to promote various goals at odds with the interest of patients. These policies and practices, Rodwin writes, tie doctors personal financial well-being to medical care providers - hospitals, medical suppliers, and pharmaceutical firms - and also to insurers and other third party payers. Doctors today are tempted to think of how they will fare financially by making particular clinical decisions. As a result, patients often receive too many or too few medical services, or the wrong kind, sometimes undergoing painful, dangerous, or unnecessary medical procedures. Rodwin shows what can be learned from the way society has coped with conflicts of interest involving other professionals (lawyers, government officials and financial professionals), all of whom are held to higherstandards of accountability than doctors. He explains, too, why simplistic solutions such as public disclosure of conflicts or government ownership of health services won t work. He offers examples of what can be done to help reduce these problems by regulation, tax policy, audi. N° de réf. du libraire LIB9780195096477

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Marc A Rodwin
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Description du livre OUP USA 1995-05-11, New York |Oxford, 1995. paperback. État : New. N° de réf. du libraire 9780195096477

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Marc A. Rodwin; Rodwin
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Description du livre Oxford University Press, 1995. État : New. N° de réf. du libraire L9780195096477

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Rodwin, Marc A.
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Marc A. Rodwin
Edité par Oxford University Press Mai 1995 (1995)
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Description du livre Oxford University Press Mai 1995, 1995. Taschenbuch. État : Neu. Neuware - This is the first systematic examination of financial conflicts of interest in medicine. Marc Rodwin examines the evolution of those medical practices and institutions that left the profession open to conflicts of interest and makes clear suggestions for reform. 411 pp. Englisch. N° de réf. du libraire 9780195096477

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