Spotlight on doctors’ referral of patients
A leading orthopaedic surgeon says patients will suffer in proposed changes to medical guidelines that could prevent clinicians from referring patients to treatments or clinics they have a financial stake in.
The New Zealand Medical Council is reviewing expectations for doctors on how to manage conflicts of interest when treating patients.
The draft guidelines state clinicians should be ‘‘very cautious’’ about referring patients to facilities where they have financial interests.
‘‘You should only do so if you have explored other options with your patient, and there is no suitable alternative that meets your patient’s needs,’’ the draft guidelines state.
But Dr Peter Robertson, a director of the private Ascot Hospitals and who also works in public orthopaedic clinics in Auckland, said that move had the potential to ‘‘totally alter the way practice occurs’’.
‘‘If you’re not allowed to ... refer patients on for testing [or] treatment under your own care, it makes a complete mockery of continuity of care,’’ he said.
The clause is an addition to existing 2012 guidelines for doctors when managing conflicts of interest. These guidelines may be used by disciplinary bodies to assess the standard of a doctor’s conduct.
In the latest edition of the New Zealand Medical Journal, Robertson said the impact of this additional clause was likely to be ‘‘detrimental’’.
‘‘It is difficult to imagine the degree of disruption of continuity of care, and system breakdown, that would occur at primary care level if the requirement for referral away from a doctor-owned practice for subsequent investigations and treatment were implemented,’’ he wrote.
‘‘[T]his approach is likely to add cost, cause delays and exacerbate capacity challenges.’’
His comments follow repeated cries from clinicians and patients that the health system is increasingly difficult to access.
The Medical Council’s chairperson, Dr Curtis Walker, in a statement said the council did not directly regulate business models adopted by doctors.
‘‘However, council does expect doctors to acknowledge and actively address any potential compromise to patient care or risk of harm to the health and safety of the public that could arise from their commercial practice.’’