Unethical business practices in U.S. health care alarm physician leaders

Physician Executive, March-April, 2005 by David O. Weber

As a physician leader, how concerned are you about unethical business
practices affecting U.S. health care today?

                           Response %     Response Total

Very concerned             54.6%           807
Moderately concerned       35.6%           527
Slightly concerned          9.2%           136
Not concerned at all        0.6%             9

Total Respondents                         1479
(skipped this question)                      3

[c]ACPE 2005 Ethical Behavior Survey

Is there a physician--or physicians--WITHIN YOUR ORGANIZATION who you
believe to be involved in unethical business practices?

                             Response %   Response Total

Yes                          33.1%         464
No                           60%           840
Not applicable                6.9%          96

Total Respondents                         1400
(skipped this question)                     82

[c]ACPE 2005 Ethical Behavior Survey

Is there a board member WITHIN YOUR ORGANIZATION who you believe to be
involved in unethical business practices?

                             Response %   Response Total

Yes                          11%           153
No                           79.6%        1111
Not applicable                9.4%         131

Total Respondents                         1395
(skipped this question)                     87

[c]ACPE 2005 Ethical Behavior Survey

Is there a non-physician leader or administrator WITHIN YOUR
ORGANIZATION who you believe to be involved in unethical business
practices?

                            Response %   Response Total

Yes                         14.2%         198
No                          79.8%        1110
Not applicable                 6%          83

Total Respondents                        1391
(skipped this question)                    91

[c]ACPE 2005 Ethical Behavior Survey

Generally speaking, questions concerning unethical behaviors and
business practices arise within my organization:

                             Response %  Response Total

Once or twice a year         42.8%        594
3 to 5 times a year          23.7%        329
More than 5 times a year     10.5%        145
Monthly                       8.1%        113
Weekly                        4.3%         59
Daily                         2.7%         37
Never                         7.9%        110

Total Respondents                        1387
(skipped this question)                    95

[c]ACPE 2005 Ethical Behavior Survey

Do you have a WRITTEN code of ethical behavior at your organization that
specifically spells out ethical policies?

                             Response %  Response Total

Yes                          70.1%        969
No                           19.1%        264
Don't know                   10.8%        149

Total Respondents                        1382
(skipped this question)                   100

[c]ACPE 2005 Ethical Behavior Survey

Does your code of ethical behavior include specific disciplinary actions
or sanctions for unethical behaviors?

                            Response %    Response Total

Yes                         73.2%         703
No                          26.8%         258

Total Respondents                         961
(skipped this question)                   521

[c]ACPE 2005 Ethical Behavior Survey

When a problem with potentially unethical business practices arises in
your organization it MOST OFTEN involves:

                                              Response %  Response Total

Physicians being influenced by                19.7%        246
pharmaceutical companies to prescribe a
certain drug.
Physicians being influenced by medical         7.8%         97
device companies to perform a certain
procedure.
Board members with conflicts of interest.      5%           62
Board members accepting gifts from vendors.    0.1%          1
Physicians under-treating patients to keep     2.7%         34
costs down and protect bonuses.
Physicians over-treating patients to boost    18.7%        234
their income.
Non-physician executive leaders accepting      1%           12
gifts from vendors.
Non-physician executive leaders with           5.1%         64
conflicts of interest.
Physicians accepting gifts from vendors.       5.7%         71
Physicians (who are not employees of a         4.6%         58
vendor) being paid to make promotional
pitches for vendors.
Physicians refusing to accept call on         13%          163
patients who don't have insurance.
Physicians inappropriately admitting           4%           50
patients to a hospital.
Physicians discharging patients from the       2.7%         34
hospital too soon to avoid length-of-stay
outliers.
Other                                         10%          125

Total Respondents                                         1251
(skipped this question)                                    230

[c]ACPE 2005 Ethical Behavior Survey

Is the code of ethical behavior enforced?

                            Response %    Response Total

Yes                         59.7%         571
No                          31.8%          81
Occasionally                              304

Total Respondents                         956
(skipped this question)                   524

[c]ACPE 2005 Ethical Behavior Survey

Is there a health care organization IN YOUR COMMUNITY that you believe
to be involved in unethical business practices?

                            Response %   Response Total

Yes                         53.8%         743
No                          46.2%         638

Total Respondents                        1381
(skipped this question)                   100

[c]ACPE 2005 Ethical Behavior Survey

Do you believe the state or federal government should adopt tougher
rules and regulations addressing unethical behaviors and business
practices in health care?

                                           Response %   Response Total

Yes, the government needs to step in.      24.7%         343
No, keep the government out of it          63.3%         879
Not sure                                   12%           166

Total Respondents                                       1388
(skipped this question)                                   94

[c]ACPE 2005 Ethical Behavior Survey

Do you believe large professional organizations should take a tougher
stand against unethical business practices?

                                            Response %  Response Total

Yes, professional organizations need to     80.8%       1123
promote tougher ethical standards
No, the current ethical standards promoted  13.5%        187
by professional groups are adequate
Not sure                                     5.7%         79

Total Respondents                                       1389
(skipped this question)                                   93

[c]ACPE 2005 Ethical Behavior Survey