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Ethical issues in pathology?
Started by ygdrasil
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oh oh I've got a good one, fee splitting. I believe medicare ruled against that this year? The idea is basically that you provide a reading for a GI doc, for example, but he takes a percentage of what you are paid by medicare (professional fee). So now he is getting paid for doing the biopsy and for "reading" the slide.
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can't say i like the sound of that . . .
i think the medico-legal issues surrounding mandatory autopsies by state medical examiners could offer some good insight. it may not be strong in terms of an ethical debate, but knowing the rules could probably help fend off debates should they come . . .
Some huge conglomerate labs (which I won't name) often undercut local labs but add in fees on the back end.
For example, the large business may bottom out their prices for reading prostate biopsies, but then they will add many unnecessary stains to the slides in order to bump up their profit margin. This way, the local lab is shut out and the stains are charged to private insurance or medicaire. Pathology and Radiology are both becoming cannibalistic in the face of decreasing reimbursement.
For example, the large business may bottom out their prices for reading prostate biopsies, but then they will add many unnecessary stains to the slides in order to bump up their profit margin. This way, the local lab is shut out and the stains are charged to private insurance or medicaire. Pathology and Radiology are both becoming cannibalistic in the face of decreasing reimbursement.
That could be a good one, particularly when the objections to a mandatory autopsy are religious in nature. In his book "Unnatural Death" Michael Baden detailed a controversial autopsy where they had to return everything (all organs, fluid, used gloves, tissue blocks and slides) with the body for purposes of burial.
http://ethicalpathology.blogspot.com/
Issues of fee-splitting, overutilization, and anti kick-back legislaton and Stark Laws are all food for fodder in this attempt to make transparent the shennanigans rife in our chosen profession.
Issues of fee-splitting, overutilization, and anti kick-back legislaton and Stark Laws are all food for fodder in this attempt to make transparent the shennanigans rife in our chosen profession.
I think I'll pursue the autopsy question. The local law school library has the Baden book, so I'll check that out. Thanks for the thought. Also, sorry about the typo on the thread's subject- it makes me wince whenever I read "patholgoy", and I can't seem to edit it.
Maybe if you became a donor? It seems that gives you some greater control over threads you start. Not sure about titles though.
BH
Looks fine to me. 😉 Kidding, i fixed it for you. I think only mods can fix thread titles.
In regards to ethical issues, ethics in medicine will almost always revolve around one of two major issues
1) Money
2) Patient safety (as in, compromising patient safety for various reasons, money included).
So when an issue comes up where people make more money by shutting others out (pod labs, mega labs, etc) something has to give. It might be quality, it might be patient care, it might be relationships with hospitals or private MDs.
