Physician self-referral

From WikiMD's Wellness Encyclopedia

Physician self-referral is a term in medical ethics and health care policy describing when a physician orders tests on a patient that are performed within the physician's own facility or in a facility from which the physician receives financial compensation. This practice has been both supported and criticized by various parties within the healthcare industry.

Overview[edit | edit source]

Physician self-referral is a practice in which a physician refers a patient to a medical facility in which he has a financial interest, be it ownership, investment, or a structured compensation arrangement. Critics of the practice argue that it may lead to conflict of interest and can result in over-utilization of services, thus driving up healthcare costs. Supporters argue that it is an efficient use of healthcare resources.

Legal aspects[edit | edit source]

In the United States, the Stark Law was enacted to limit the amount of self-referrals made by physicians. The law, named after Congressman Pete Stark, prohibits a physician from referring Medicare patients for certain health services to an entity in which the physician (or a member of his or her family) has an ownership/investment interest or with which he or she has a compensation arrangement, unless an exception applies.

Criticism[edit | edit source]

Critics of physician self-referral argue that it leads to increased healthcare costs as it may encourage over-utilization of services. They also argue that it can lead to less than optimal patient care if the referred facility is not the best choice for the patient's condition.

Support[edit | edit source]

Supporters of physician self-referral argue that it can lead to efficiencies in the healthcare system as it can reduce the time between diagnosis and treatment. They also argue that it can lead to better coordination of care as the referring physician is more likely to follow up on the patient's treatment.

See also[edit | edit source]

Physician self-referral Resources
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Contributors: Prab R. Tumpati, MD