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March 2020

Ethics Corner

Ethics Corner

John P. Lubicky, MD, FAAOS, FAAP
Ethics & Professionalism Committee Member

TRIBULATIONS OF SELF REFERRAL:
Revisiting the Stark Laws and Professional Ethical Considerations

In the bygone days of medicine, physician advertising and entrepreneurship were foreign concepts to doctors in everyday practice. Doctors provided specific services and hospitals provided others. Dramatic changes in the cost of medical education, the evolution of healthcare systems, new technology, third party payers (private and government based), patient demand and other factors have changed the paradigm. New doctors faced significant medical school debt repayments, and often encountered healthcare facilities that could not, or would not, respond to their need to increase patient volume and efficiency that might have favorably impacted their incomes. Physicians soon realized that providing ancillary services via physician-owned facilities could address some of these concerns.