Ethics Corner

Ethics Corner

Jonathan N. Sembrano, MD
Ethics & Professionalism Committee Member

How does a physician avoid unethical self-referral practice when simultaneous practicing within and outside a government health system?

Many spine surgeons have dual employment, wherein they are part-time employees at a government facility, such as the Veterans Affairs (VA) Health Care System, and a non-government facility (private/academic institution). It is not unusual for patients seen at the government facility to be deemed by the surgeon, for one reason or another, to be more appropriately managed at another facility. Oftentimes, the surgeon also feels that his/her other practice site is the best facility to handle this problem. This then brings up the question of whether this type of practice represents abuse of government employment for self-gain.