The Practice of Medical Referral: Ethical Concerns

摘要

Medical referral is the act of sending a patient by one professional care giver to another, who may be a specialist and therefore be more knowledgeable in the diagnosing and further management of the patient. Most cases of referral of patients is therefore for proper diagnosis, adequate investigations and their proper treatment by the receiving specialists. It is mostly assumed and believed that patients depend on the medical information available to their health care providers. Therefore, the need for a referral, its appropriatness, timing and to whom the referral is made to mostly depends on the attending physician. This should be done after due consultation with the patients family and appropriate consent obtained. It is believed that a health practitioner should make a referral when he thinks that it will be of benefit to the patient and not when he wants to avoid the challenges of unraveling the patients’ complex problems. Also, referral should not be made to avoid possible death of the patient in a hospital so as not to worsen its statistics. Unfortunately, the seemingly good intention of referring of patients may cause a conflict of interests when physicians because of inherent financial gains refer patients to facilities that they own or have investment interest in. Such referral challenges as self-referral, and fee-splitting whereby a fee is paid to one physician by another for a referral is unethical, and are known to occur. Several “Anti-referral Laws” have subsequently been set up to prevent such actions and protect patients against abuse by health workers.