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A seemingly inevitable circumstance of the deranged privatised healthcare system in the US which allows the dangling of a near irresistible carrot of financial gain in front of doctors by a plethora of medical drug/device companies. Whilst this is, without doubt, an extreme example of what such a system can lead to, it is simply the ugliest peak breaking through the surface waters of what is an otherwise colossal hidden iceberg of such practise. Other clinicians may not carry out sham procedures or insert frankly harmful devices unnecessarily, but the related notion of 'Physician Induced Demand' where figures have shown a reactive increase in the prescription of otherwise plateauing procedures in response to remuneration cuts for said procedures, we can clearly see that a system in which clinicians have such a level of control will end up self-prioritising as opposed to patient-centric.
The concept of 'Physician Owned Distributorships' should not only be discouraged or warned against, but made wholly illegal, as it will clearly always allow scope for such abuse of power. The doctor-patient relationship is one of agency - doctors are responsible for making informed and balanced decisions in the best interests of the patients and recommending these to them. The patients concede that doctors are the ones with expert information, and this information asymmetry is the perfect breeding ground for abuse when scope for massive financial gain is introduced.
Who do we blame - the one who bites the carrot or those who let it be dangled?
A seemingly inevitable circumstance of the deranged privatised healthcare system in the US which allows the dangling of a near irresistible carrot of financial gain in front of doctors by a plethora of medical drug/device companies. Whilst this is, without doubt, an extreme example of what such a system can lead to, it is simply the ugliest peak breaking through the surface waters of what is an otherwise colossal hidden iceberg of such practise. Other clinicians may not carry out sham procedures or insert frankly harmful devices unnecessarily, but the related notion of 'Physician Induced Demand' where figures have shown a reactive increase in the prescription of otherwise plateauing procedures in response to remuneration cuts for said procedures, we can clearly see that a system in which clinicians have such a level of control will end up self-prioritising as opposed to patient-centric.
The concept of 'Physician Owned Distributorships' should not only be discouraged or warned against, but made wholly illegal, as it will clearly always allow scope for such abuse of power. The doctor-patient relationship is one of agency - doctors are responsible for making informed and balanced decisions in the best interests of the patients and recommending these to them. The patients concede that doctors are the ones with expert information, and this information asymmetry is the perfect breeding ground for abuse when scope for massive financial gain is introduced.
Competing interests: No competing interests