Abstract Some attention is beginning to be paid in the recent literature of bioethics and health policy to a variety of ethical issues that arise in the business aspects of the practice of medicine. These include such questions as advertising in medicine, physician self-referral, physician fees, and conflicts of interest in clinical trials. These questions arise primarily, but not exclusively, in those settings in which physicians practice fee-for-service medicine, and there are many such settings in the United States and elsewhere. I want to suggest that the controversies surrounding these issues result from neither society in general nor physicians in particular having decided which of two models of the physician is the more appropriate model, and that progress in resolving these issues requires an unequivocal adoption of one of them. In the first section of this article, I will present an outline of these two models. In the next two sections, References 1. Dyer AR. Ethics, advertising, and the definition of a profession . J Med Ethics . 1985;11:72-78.Crossref 2. Council on Ethical and Judicial Affairs. Annotated Current Opinions . Chicago, Ill: American Medical Association; 1992;6.11. 3. American College of Physicians. ACP ethics manual . Ann Intern Med. 1989;111:245-252.Crossref 4. Rodwin MA. Medicine, Money, and Morals . New York, NY: Oxford University Press; 1993. 5. Council on Ethical and Judicial Affairs. Conflict of Interest: Reports of the Council on Ethics and Judicial Affairs . Chicago, Ill: American Medical Association; 1986. 6. Council of Ethical and Judicial Affairs. Conflict of Interest: Update: Reports of the Council on Ethical and Judicial Affairs . Chicago, Ill: American Medical Association; 1989. 7. Council on Ethical and Judicial Affairs. Conflicts of interest . JAMA . 1992;267:2366-2369.Crossref 8. Hillman BJ, Joseph CA, Malry MR, Sunshine JH, Kennedy SD, Noether M. Frequency and costs of diagnostic imaging in office practice . N Engl J Med. 1990;323:1604-1608.Crossref 9. Physician ownership of, and referral of patients or laboratory specimens to, ethics furnishing clinical laboratory or other health service . Federal Register . (March 11) , 1992;57:8588-8604.
Archives of Otolaryngology - Head & Neck Surgery – American Medical Association
Published: May 1, 1993