As your doctor, it is important to me that you know my feelings about financial issues in our relationship. It's especially important that you know how I deal with the ethical conflicts which arise from insurance plans, and other financial influences upon the decisions we make together.
My greater wish as a doctor is that you judge my care to be the best possible, according to your personal standards. For this to be true, I need to earn your trust as an ethical person, as well a skillful practitioner. I want you to know that, among the values that govern my practice, I make the following promises to you:
I will treat you as a person, first and always, and not as means of creating profits for me or anyone else.
I will never deceive you about my motives or intentions; I will not withhold information I believe you should know when I recommend a plan of treatment. My advice will always consider what is best for you as a person, regardless of its financial implications for you, your insurance company or anyone else, including me.
I believe in cost-conscious care as a secondary goal of a good health system. I will be sensitive to financial issues that affect you. I will help you discover the costs of treatment and assist you in finding the most effective use of your money for the sake of your health. I will help you distinguish between decisions based on costs as opposed to other factors.
Regardless of the payment arrangement between us, every treatment or recommendation that I provide will be based on my belief that it is in your best interest. I will not participate in any plan which offers me compensation so heavily weighted toward cost containment that it could create a temptation to place this factor above your welfare. Nor will I offer you treatments on a fee-for-service basis that are inappropriate, unnecessary or at unreasonable fees.
Occasionally a procedure may have little hope of benefit or may not be "covered" by your insurance, yet might still be appropriate for you to consider I will support you in asking your insurance plan to pay for any reasonable treatment, regardless of plan policy. And, I may also encourage you to pay for "uncovered" items which I believe offer valuable benefits not available under your plan. However, I will advise you against procedures which are wasteful, frivolous or irrational.
If I foresee a conflict between your welfare and any policy, contract, guideline, standard or law, I will disclose it to you. In the presence of uncertainty, I will help you choose a course of action that recognizes your values. On medical issues, I will not place my personal interests above yours, nor will I cooperate with others in doing so.
Finally, if I feel that you or anyone is contemplating a course of action that is not in your best interest, I will advise you of this.
Whatever form your health coverage takes, I intend always to deal honorably with you, your insurance company and everyone else in the system. Please let me know at any time you have a concern about the completeness, accuracy, or bias of any information you have received from me, my staff, or any consultant or organization to whom I have referred you.