Conflicts of Interest

TLDR

The Council on Ethical and Judicial Affairs has issued safeguards against self‑referral since 1986, updated in 1989, but recent studies show ongoing problems that undermine physician professionalism, leading the Council to prohibit referrals to facilities where physicians have investment interests unless community need and lack of alternative financing justify it. In this report, the Council on Ethical and Judicial Affairs revisits the question of referral of patients to medical facilities in which physicians have financial interests (“self‑referral”). JAMA 1992;267:2366‑2369.

Abstract

In this report, the Council on Ethical and Judicial Affairs revisits the question of referral of patients to medical facilities in which physicians have financial interests ("self-referral"). The Council issued safeguards in 1986 to prevent abuses of self-referral and most recently updated the guidelines in 1989. Recent studies, however, have suggested that problems with self-referral persist; these problems undermine the commitment of physicians to professionalism. The Council has concluded that, in general, physicians should not refer patients to a health care facility outside their office practice at which they do not directly provide care or services when they have an investment interest in the facility. Physicians may invest in and refer to an outside facility if there is a demonstrated need in the community for the facility and alternative financing is not available. (<i>JAMA</i>. 1992;267:2366-2369)