A look at how doctors respond to ethical questions

Doctors face a range of ethical questions, from the clinical to the emotional. Would you avoid a treatment that might be most effective because the patient’s insurance won't pay for it? Is it okay to become romantically involved with a patient?

Medscape polled more than 7,500 physicians from more than 25 specialties on questions related to money, romance and patient care. Results of the survey show most doctors are still putting their patients first.

The majority of respondents, or 78%, said they would not deny or avoid treatment to a patient in the face of financial penalties, for example. 

Other physicians warned that as more doctors become salaried employees of hospitals and healthcare systems, they will be under more pressure to bend. “This will become a more and more common practice as physicians become corporate employees rather than their own person,” said one doctor who responded to the survey. “When this occurs and keeping your job entails toeing the corporate line, ethics will take a back seat.”

Hospital ownership of physician practices is on the rise, with 38% of U.S. physicians now employed by hospitals and health systems. Although hospital employment may take the pressure off doctors, it may not be good for the health system as a whole--it could mean higher costs for the industry and impact both where patients receive care and how much they pay for it, said Kelly Kenney, Physicians Advocacy Institute executive vice president.

RELATED: 1 in 4 physician practices now hospital-owned

Still only a small share of doctors (11%) say they would decline a potentially more effective treatment because a patient’s insurance won’t pay for it.

Medscape found the percentage of doctors saying it's OK to become romantically involved with a patient or former patient has increased over the years. However, most physicians (70%) say such relationships are off limits, the survey found.

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