AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. January 2005, Volume 7, Number 1.

Module 6

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Case 6.2: Financial Incentives—The 50-Milligram Difference

Option Assessment

A.  

Informing Mr. Ria that he will write the prescription for 100-mg should be avoided. It violates Opinion 8.054, "Financial Incentives and the Practice of Medicine," which states that physicians' "first duty must be to the individual patient. This obligation must override considerations of the reimbursement mechanism or specific financial incentives applied to a physician's clinical practice."

B.  

Writing the prescription for 50-mg is acceptable. It is supported by Code Opinion 8.054, "Financial Incentives and the Practice of Medicine": physicians "first duty must be to the individual patient. This obligation must override considerations of the reimbursement mechanism or specific financial incentives applied to a physician's clinical practice."

C.  

Informing Mr. Ria of Dr. Troy's financial incentive to write the larger prescription and asking if he would be willing to get the 100-mg prescription is preferable; it is the most reasonable option and is supported by the Code in Opinion 8.054, "Financial Incentives and the Practice of Medicine": "patients must be informed of financial incentives that could impact the level or type of care they receive."

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