Physicians admit deception to get patients coverage
Almost 40% of physicians say they have exaggerated a patient's condition to an insurance company to make sure the patient has coverage for needed treatment or time in the hospital, according to a recent survey conducted by the Chicago-based American Medical Association (AMA).
"Physician deception of third-party payers is prevalent and may be rising," according to AMA.
The most common forms of deception include: exaggeration of severity of the patient's condition in order to avoid early discharge from the hospital; changing billing diagnosis to secure services; reporting symptoms that the patient did not have in order to obtain coverage and treatments.
Overall, 39% of physicians reported that they had used one of the three forms of deception, according to the sample of 724 doctors in primary care medicine. The data were collected by the AMA from its survey of physicians, "Meeting Patients' Needs in the Modern Era."
While physicians' use of deception may benefit individual patients, it also may damage the patient-physician relationship, cause moral discomfort for physicians, subvert resource allocation systems, and put physicians at risk of prosecution for fraud, the researchers concluded.
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