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.

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