Is Professional Courtesy Dead among Physicians?

Going back to the time of Hippocrates, physicians have provided medical treatment to their colleagues and their colleagues’ family members without charge. The rationale was to discourage physicians from treating themselves and their family members and also to encourage professional courtesy among physicians.

It is rare today that physicians have the time, desire, or financial means to take on patients without charge. However, if a physician is in position to do so, the rules of the game still apply. You still need to treat a pro bono patient EXACTLY as you would treat a paying patient.

You need to do a physical examination and document in the patient’s chart all the medications you prescribe and the treatment plan. Too often, I have had physicians tell me in my office that they did not create a chart because they were “not billing insurance.” This is improper. The State Medical Board of Ohio does not have different rules for the treatment of patients who you charge and those you do not charge. The Medical Board never even asks if you were paid for the treatment. This is not the standard.

The American Medical Association has also drafted an Opinion on Professional Courtesy and it states that while “professional courtesy is a long-standing tradition in the medical community, it is NOT an ethical requirement”. The Opinion also warns physicians that they should be aware that accepting insurance payments while waiving patient co-payments may violate AMA Opinion 6.12 “Foregiveness or Waiver of Insurance Co-Payment .” American Medical Association Opinion 6.13.  In addition, in Ohio, it is against the law to waive an insurance co-pay for a patient or to advertise that you will waive an insurance co-pay. Ohio Revised Code 4731.22(B)(28)(a) and (b).

If you want to provide medical treatment to another for free you may do so as a professional courtesy. However, you may not bill insurance and waive the co-payment to the patient.  You must provide treatment to this patient in the same manner and in accordance with the same medical and legal laws, rules and standards applicable to all other patients.

As always, if you have any questions about this post or about the State Medical Board of Ohio, you may contact any of the attorneys at Collis, Smiles and Collis in Columbus, Ohio at 614-486-3909.

Physicians .. Do your CMEs or face Ohio Medical Board discipline

Each month I attend the monthly meeting of the State Medical Board of Ohio.  This past week, at the Board’s monthly meeting, I was stunned to hear that the Board had voted to accept the permanent surrender of four physician’s licenses for failure to comply with their Continuing Medical Education (CME) requirements! This means four physicians in the state of Ohio chose to permanently surrender their medical licenses for failure to comply with the Board’s CME requirements. While many of these physicians may be older doctors who no longer want to practice, I was saddened to hear that they chose to permanently surrender their licenses under such circumstances.

All physicians in Ohio are required to complete 100 hours of CME credits every two years. 40 hours of that 100 must be Category A approved hours and the remaining 60 hours can be completed by simply reading medical journals. There are many on-line or in person locations that you can obtain CME approved hours. You may contact your local medical association or the Ohio State Medical Association for approved credit hours.  https://www.osma.org/education/continuing-medical-education-requirements.

You are required to maintain documentation of your meeting attendance. Each year, the Medical Board conducts random audits and requests that selected physicians submit proof of completion of their CME hours.

Failure to respond timely to an audit can result in a Reprimand to your professional license. If you are unable to provide evidence that you completed the required CME credits during your two-year renewal period, the Board may issue for a first time offense a Reprimand and a fine ranging from $1000-$5000. The Board may also indefinitely suspend your medical license until you have completed all your CME hours.

For a second time offense, the Board can impose a sanction of a fine from $3000-$5000 and can suspend your license for an indefinite period of time ranging from a 60-90 day suspension.

Keep track of your CME credits. Keep copies of all meetings you attend and journals you read. It is not worth the risk of discipline to your professional license including a fine, Reprimand or Suspension for failure to complete your required CME hours.

As always, if you have any questions about this post or the State Medical Board of Ohio, you may contact any of the attorneys at Collis, Smiles and Collis in Columbus, Ohio, 614-486-3909.