Unethical Business Practices in U.S. Health Care Alarm Physician Leaders Pros and Cons: The Eye of the Beholder  
Ethical Challenges Abound
 Practicing Preventive Ethics—The Keys to Avoiding Ethical Conflicts in Health Care  
1. As a physician leader, how concerned are you about unethical business practices affecting U.S. health care today?
  Response Percent Response Total
    Very concerned
 54.6% 807
    Moderately concerned
 35.6% 527
    Slightly concerned
 9.2% 136
    Not concerned at all
 0.6% 9
Total Respondents   1479
(skipped this question)   3
2. Please indicate the level of your concern about the potentially unethical business practices listed below:
Very Concerned Moderately Concerned Slightly Concerned Not Concerned Response Average
Physicians being influenced by pharmaceutical companies to prescribe a certain drug.
36% (516) 40% (570) 20% (279) 4% (61) 1.92
Physicians being influenced by medical device companies to perform a certain procedure.
39% (558) 40% (575) 16% (230) 4% (58) 1.85
Board members with conflicts of interest.
33% (461) 33% (473) 27% (378) 7% (104) 2.09
Board members accepting gifts from vendors.
27% (379) 29% (407) 28% (391) 16% (229) 2.33
Physicians under-treating patients to keep costs down and protect bonuses.
29% (406) 22% (309) 32% (450) 18% (255) 2.39
Physicians over-treating patients to boost their income.
45% (633) 33% (470) 19% (266) 4% (50) 1.81
Non-physician executive leaders accepting gifts from vendors.
26% (366) 30% (424) 31% (445) 13% (178) 2.31
Non-physician executive leaders with conflicts of interest.
34% (484) 32% (459) 26% (367) 8% (110) 2.07
Physicians accepting gifts from vendors.
24% (338) 36% (511) 33% (463) 7% (97) 2.23
Physicians (who are not employees of a vendor) being paid to make promotional pitches for vendors.
28% (399) 35% (496) 28% (396) 9% (127) 2.18
Physicians refusing to accept call on patients who don't have insurance
59% (845) 21% (304) 14% (195) 5% (77) 1.65
Physicians inappropriately admitting patients to a hospital
30% (424) 24% (348) 32% (451) 14% (198) 2.30
Physicians discharging patients from the hospital too soon to avoid length-of-stay outliers
28% (395) 26% (365) 33% (465) 14% (194) 2.32
Total Respondents   1423
(skipped this question)   59
3. Is there a physician -- or physicians -- WITHIN YOUR ORGANIZATION who you believe to be involved in unethical business practices?
  Response Percent Response Total
    Yes
 33.1% 464
    No
 60% 840
    Not applicable
 6.9% 96
Total Respondents   1400
(skipped this question)   82
4. Is there a board member WITHIN YOUR ORGANIZATION who you believe to be involved in unethical business practices?
  Response Percent Response Total
    Yes
 11% 153
    No
 79.6% 1111
    Not applicable
 9.4% 131
Total Respondents   1395
(skipped this question)   87
5. Is there a non-physician leader or administrator WITHIN YOUR ORGANIZATION who you believe to be involved in unethical business practices?
  Response Percent Response Total
    Yes
 14.2% 198
    No
 79.8% 1110
    Not applicable
 6% 83
Total Respondents   1391
(skipped this question)   91
6. Is there a health care organization IN YOUR COMMUNITY that you believe to be involved in unethical business practices?
  Response Percent Response Total
    Yes
 53.8% 743
    No
 46.2% 638
Total Respondents   1381
(skipped this question)   100
7. Generally speaking, questions concerning unethical behaviors and business practices arise within my organization:
  Response Percent Response Total
    Once or twice a year
 42.8% 594
    3 to 5 times a year
 23.7% 329
    More than 5 times a year
 10.5% 145
    Monthly
 8.1% 113
    Weekly
 4.3% 59
    Daily
 2.7% 37
    Never
7.9% 110
Total Respondents   1387
(skipped this question)   95
8. When a problem with potentially unethical business practices arises in your organization, it MOST OFTEN involves: (CHOOSE ONE ANSWER ONLY)
  Response Percent Response Total
    Physicians being influenced by pharmaceutical companies to prescribe a certain drug.
 19.7% 246
    Physicians being influenced by medical device companies to perform a certain procedure.
 7.8% 97
    Board members with conflicts of interest.
 5% 62
    Board members accepting gifts from vendors.
 0.1% 1
    Physicians under-treating patients to keep costs down and protect bonuses.
 2.7% 34
    Physicians over-treating patients to boost their income.
 18.7% 234
    Non-physician executive leaders accepting gifts from vendors.
 1% 12
    Non-physician executive leaders with conflicts of interest.
 5.1% 64
    Physicians accepting gifts from vendors.
 5.7% 71
    Physicians (who are not employees of a vendor) being paid to make promotional pitches for vendors.
 4.6% 58
    Physicians refusing to accept call on patients who don't have insurance
13% 163
    Physicians inappropriately admitting patients to a hospital
 4% 50
    Physicians discharging patients from the hospital too soon to avoid length-of-stay outliers
 2.7% 34
    Other
10% 125
Total Respondents   1251
(skipped this question)   230
9. Do you have a WRITTEN code of ethical behavior at your organization that specifically spells out ethical policies?
  Response Percent Response Total
    Yes
 70.1% 969
    No
 19.1% 264
    Don't know
 10.8% 149
Total Respondents   1382
(skipped this question)   100
10. Does your code of ethical behavior include specific disciplinary actions or sanctions for unethical behaviors?
  Response Percent Response Total
    Yes
 73.2% 703
    No
 26.8% 258
Total Respondents   961
(skipped this question)   521
11. Is the code of ethical behavior enforced?
  Response Percent Response Total
    Yes
 59.7% 571
    No
 8.5% 81
    Occasionally
 31.8% 304
Total Respondents   956
(skipped this question)   524
12. Do you believe large professional organizations should take a tougher stand against unethical business practices?
  Response Percent Response Total
    Yes, professional organizations need to promote tougher ethical standards
 80.8% 1123
    No, the current ethical standards promoted by professional groups are adequate
 13.5% 187
    Not sure
 5.7% 79
Total Respondents   1389
(skipped this question)   93
13. Do you believe the state or federal government should adopt tougher rules and regulations addressing unethical behaviors and business practices in health care?
  Response Percent Response Total
    Yes, the government needs to step in.
 24.7% 343
    No, keep the government out of it
 63.3% 879
    Not sure
 12% 166
Total Respondents   1388
(skipped this question)   94

14. Please choose the category below that best describes your title or position