Official websites use. Share sensitive information only on official, secure websites. The regulation of private health care has become a central issue in Canadian health policy. The legality of private markets for medical services already available under public health insurance has attracted attention. There may be IHFs in Ontario alone.
IHFs depend on physician referrals for patients. This raises 2 important issues. First, IHFs can compensate physicians for patient referrals a kickback , a practice that can potentially distort clinical judgement. Second, physicians can make referrals to IHFs that they themselves own, raising similar concerns.
Both problems have occurred in the United States and have prompted regulation. Financial conflicts of interest involving physicians are regulated by common law, which imposes a fiduciary duty on physicians toward patients. The courts acknowledge that the professional regulatory bodies such as the provincial colleges of physicians and surgeons may have the greatest expertise in governing conflict of interest.
In some respects, these rules adequately protect patients; in others, they do not. We propose regulatory models to be implemented before the further proliferation of IHFs. The term kickback refers to the financial compensation of physicians for patient referrals. Compensation can flow from IHFs to referring physicians, or from specialists to primary care physicians fee-splitting.
Compensation can consist of cash payments for each referral, discounted office space or leases for medical equipment, or business loans at below-market rates. Compensation for referrals is unobjectionable in most markets, but is problematic in health care in view of the potential conflict between physicians' financial self-interest and their duty to advise patients solely on the basis of health needs.
