Professional Obligations When Patients Pay Out of Pocket

This article examines the ethical responsibility of physicians to their patients when patients' health care decisions are influenced by financial considerations. As consumer-directed health care increases the amount of money patients pay out of pocket for medical services, new responsibilities emerge for physicians. The authors reviewed professional ethics literature and interviewed seven primary care physicians who work with lower-income patients to develop practical principles and strategies.

Key Findings:

  • While discussions about finances are difficult, physicians have an ethical responsibility to their patients to address these issues when relevant to care.
  • When discussing financial issues with patients, it is best to approach the topic in a forthright manner and to share any knowledge of treatment costs.
  • Situations may arise when physicians must recommend sub-optimal treatment due to the financial considerations of patients.

The financial aspects of medical care are complex and present a new set of challenges to physicians seeking to give patients the best care available.