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The Bander Center for Medical Business Ethics at Saint Louis University regularly compiles links to case studies useful for class discussion, legal resources, codes, guidelines and reports related to medical business ethics.

Bander Center Casebook

Controversial Cases in Malpractice and Negotiation: An Interactive Session for Clinical Medical Students

Codes and Reports

Ethical Guidelines/Opinions
  • Institute of Medicine (IOM) of the National Academies: Board on Health Sciences Policy, Report on Conflict of Interest in Medical Research, Education, and Practice
Reports from the Association of American Medical Colleges (AAMC)
  • The Scientific Basis of Influence and Reciprocity: A Symposium (2007)
  • Report of the AAMC Task Force on Industry Funding of Medical Education to the AAMC Executive Council (2008)
  • Protecting Patients, Preserving Integrity, Advancing Health: Accelerating the Implementation of COI Policies in Human Subjects Research(2008)
  • In the Interest of Patients: Recommendations for Physician Financial Relationship and Clinical Decision Making (2010)

Legal Resources

Federal and local governments have generated laws and authoritative regulations to enforce the management of conflicts of interest and encourage ethical business practices in medicine.

Federal Regulations
  • Anti-Kickback Regulation (42 U.S.C. 1320a-7b)
  • False Claims Act (31 U.S.C. 3729)
  • Safe Harbor Regulations
  • U.S. Department of Health & Human Services: Office of the Inspector General (OIG)
    Offers physician education training materials about Federal fraud and abuse laws and avoiding Medicare and Medicaid fraud and abuse.
  • A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse - a physician self study guide that covers pertinent laws on fraud and abuse and appropriate relationships with fellow providers, vendors, and payers.
Health Care Reform
  • H.R.3200 - America's Affordable Health Choices Act of 2009
    Signed into law on March 23, 2010.
  • Patient Physician Sunshine Act Provision (Requirements on financial relationships between manufacturers and distributors of covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid, or CHIP and physicians and other health care entities and between physicians and other health care entities, including disclosure). This component of the bill requires that starting in 2012, medical device and pharmaceutical companies will record physician payments over $10 and that all payments be publicly disclosed.

Case Studies

AMA Journal of Ethics Clinical Case Studies

(All cases gathered from the AMA Journal of Ethics website)

American College of Physicians Case Study Series

American College of Physicians (All cases gathered from the American College of Physicians)

  • Are Health Plan Incentives Hurting Generalist-Specialist Relationships? - A physician struggles with limitations and pressures put onto her and other physicians by HMOs.
  • When are Industry-Sponsored Trials a Good Match for Community Doctors? - When community physicians are paid for enrolling patients into a clinical trial, the lines between physician and researcher can become blurred.
  • Physician Work Stoppages and Political Demonstrations: Economic Self-Interest or Patient Advocacy? Where is the Line? - Should a physician group shut down their practice for a day to attend a tort reform demonstration?
  • The HMO Physician's Duty to Cut Costs - A physician has a duty to providing the best treatment for his patient, but does a similar duty apply to providing treatment at the most reasonable cost? (Link to JSTOR Article available with SLU access)

More cases on topics in medical business ethics are currently being developed. For comments and suggestions, please contact us at 314-977-1070.