Ethical Dilemma

[daniel2013]

If your partner is a pediatrician, is it unethical for her/him to refer patients to you the optometrist? This question is implying that there are many other optometrists in the area -your not the only game in town-. This question is also implying that by refering to you, yourself, your partner and your practice will benefit greatly from this arrangment as you will have lots of referrals. Is it ethical for one medical professional to refer to another - when there is a intrinsic monetary benefit, aside from patient care?

-Ive gotten some mixed responses from this, I couldent think of a better place to take this question.

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[KHE]

If your partner is a pediatrician, is it unethical for her/him to refer patients to you the optometrist? This question is implying that there are many other optometrists in the area -your not the only game in town-. This question is also implying that by refering to you, yourself, your partner and your practice will benefit greatly from this arrangment as you will have lots of referrals. Is it ethical for one medical professional to refer to another - when there is a intrinsic monetary benefit, aside from patient care?

-Ive gotten some mixed responses from this, I couldent think of a better place to take this question.

This is a bit of a grey area.

In general, you're not supposed to benefit monetarily from your referrals. However, if you're making the referal because the patient needs it, I don't have a problem with it.

I would probably simply say "hey....you're kid needs to see an optometrist. My wife/husband is an optometrist and I'm happy to have you see them or if you have an optometrist you already see, that's perfect too."

That way you've given full disclosure and given them the option.

 

[michaelrack]

assuming the optometrist isn't enrolled in medicare (as a provider), I don't think there are any legal problems involved.

 

[DrVinzKlortho]

assuming the optometrist isn't enrolled in medicare (as a provider), I don't think there are any legal problems involved.

I'm not sure that's 100% accurate. I think more specifically if the patient isn't utilizing Medicare part B for the direct referral. I don't think having the provider being enrolled in Medicare has anything to do with it. Only if the referring doctor will directly or indirectly (family member) benefit financially from part B goods as this would be direct violation of the Stark law. One of the loop-holes of the Stark law is referral for physician services.

 

[michaelrack]

I'm not sure that's 100% accurate. I think more specifically if the patient isn't utilizing Medicare part B for the direct referral. I don't think having the provider being enrolled in Medicare has anything to do with it. Only if the referring doctor will directly or indirectly (family member) benefit financially from part B goods as this would be direct violation of the Stark law. One of the loop-holes of the Stark law is referral for physician services.

You are probably right about Stark, though there are other rules that could apply- especially the anti-kickback statute http://www.netreach.net/~wmanning/fasumm.htm.

If the pediatrician refers privately insured patients to the optometrist and later sees a patient of the optometrist who happens to have medicare, this statute could potentially apply.

 

[Tippytoe]

If your partner is a pediatrician, is it unethical for her/him to refer patients to you the optometrist? This question is implying that there are many other optometrists in the area -your not the only game in town-. This question is also implying that by refering to you, yourself, your partner and your practice will benefit greatly from this arrangment as you will have lots of referrals. Is it ethical for one medical professional to refer to another - when there is a intrinsic monetary benefit, aside from patient care?

-Ive gotten some mixed responses from this, I couldent think of a better place to take this question.

Ammm,....you couldn't think of a better place to ask this question than a student doctor site? ODwire.org is full of professionals that could better answer your question including a couple of OD/lawyers.

But I think the bottom line is that as long as you don't have some sort of pre-arranged "deal" where you he sends all his patients to you for eye exams and you send all you patients to him for exams, you're okay. In other words, referrals are referrals as long as you don't have an implicit, "you scratch my back- I'll scratch your back" written or unwritten protocol.

Otherwise, I think an OD/ Peds partnership is a great deal for everyone involved, esp the patients. And of course, when we say partnership, most states have very strick guidelines for allowing MDs to partner with lowly ODs (or DCs ect.....),. It's forbidden in many states. Of course you could share an office as seperate business.

 

[Poetic Silence]

Ammm,....you couldn't think of a better place to ask this question than a student doctor site? ODwire.org is full of professionals that could better answer your question including a couple of OD/lawyers.

But I think the bottom line is that as long as you don't have some sort of pre-arranged "deal" where you he sends all his patients to you for eye exams and you send all you patients to him for exams, you're okay. In other words, referrals are referrals as long as you don't have an implicit, "you scratch my back- I'll scratch your back" written or unwritten protocol.

Otherwise, I think an OD/ Peds partnership is a great deal for everyone involved, esp the patients. And of course, when we say partnership, most states have very strick guidelines for allowing MDs to partner with lowly ODs (or DCs ect.....),. It's forbidden in many states. Of course you could share an office as seperate business.

I feel fairly certain the OP's "partnership" is marital one.

If this is the case, the ethical obligation would be to offer the patient the choice of seeing you or another provider.

 

[Meibomian SxN]

But I think the bottom line is that as long as you don't have some sort of pre-arranged "deal" where you he sends all his patients to you for eye exams and you send all you patients to him for exams, you're okay. In other words, referrals are referrals as long as you don't have an implicit, "you scratch my back- I'll scratch your back" written or unwritten protocol..

I agree. As long as there is no kickbacks going on then its completely legal and ok. I guess you can't host dinner CEs or wine & cheese baskets between the 2 of you. lol

 

[daniel2013]

I apologize for any confusion guys, I really meant a 'spousal relationship' when I was referring to partnership