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Dollars for Docs: Busting Out Your Doctor's Side Business

Written By: Brenda (B.K.) Walker

October 2015

Hardly a day goes by that there’s not some type of heated debate over the cost of health care in the United States. Whether you are pro or anti-Obama Care—one thing everyone agrees onthis country has to get control of health care expenditures.

Here’s the problem—everybody blames everybody for why health care is so expensive, AND—everyone has an excuse as to why their part of the expenditures are so high.

There’s a lot of finger pointing by and at health insurance carriers, big pharma, and, of course, health care providers.

Most people expect that trained medical professionals would earn a good living. After all, look at how many years of school they must attend, the years of training involved, tuition costs, and liability insurance—all of this basically dictates that these individuals should draw a larger salary than the "average Joe."

Back in the USA News Story: Dollars for Docs: Busting Out Your Doctor’s Side Business.

But what about the hidden advantages these health providers reap—under the radar—non-taxable—advantages that the "average Joe" is likely completely unaware are going on behind closed doors—sometimes while “good ole Joe” is patiently waiting to see the doctor. Are these merely "advantages" or are they the equivalent of a "side-business."

The Pharma Pay-Off

Have you ever wondered why your health care provider chooses certain brands of prescription medication over another? Now, nobody’s saying that it has anything to do with "big pharma perks," but…

From NPR, Ana Stankovic, a New Hampshire nephrologist, "...received payments on 242 different days," from "29 different pharmaceutical companies paid her $594,363 in 2014..."

From ProPublica, Maryland Family Medicine Specialist, Juichih Hsu, "...received payments on 286 days of 365, more than anyone else. Sometimes, she received meals from several drug companies on the same day."

"'There are physician practices which have very deep relationships with pharmaceutical representatives, where they are a very integral part of the practices,' said Dr. Aaron Kesselheim, and associate professor of medicine at Harvard Medical School who has written about industry relationships with doctors. 'Every day it's another drug company and some are bringing lunch and it's just part of the culture of the practice.'"

Open Payments

One nifty bi-product of the Affordable Care Act (Obamacare) is that the Centers for Medicare and Medicaid Services (CMS) is now required to track certain information, including these "perk-payments." From CMS,

Back in the USA News Story: Dollars for Docs: Busting Out Your Doctor’s Side Business.

"Sometimes, doctors and hospitals have financial relationships with health care manufacturing companies. These relationships can include money for research activities, gifts, speaking fees, meals, or travel. […] Open Payments is the federally run program that collects the information about these financial relationships and makes it available to you."

According the, Total US Dollar Value of these types of payments for 2014 amounted to $6.49 billion dollars.

Prosecuted for Taking Bribes

It's not on cake and ice cream for clinicians who get caught up in the web of "pay-off perks." The State of New Jersey indicted five medical practitioners under bribery charges for "referring patients to medical imaging centers run by criminal enterprise."

  • Dr. John Fritz-from 2006-2013 suspected of "referring approximately 4,500 scans to Zuberi-controlled imaging facilities in exchange for approximately $500,000 in kickbacks."
  • Dr. Alexander G. Salerno-"...allegedly referred thousands of scans to Zuberi imaging centers from 2009-2013 for which he received approximately $130,000 in kickbacks."
  • Dr. Davarajan Iyengar-allegedly "from 2007-2012...participated in a scheme by which he referred patients to Zuberi-controlled medical imaging centers for MRI and CT scans in exchange for approximately $75,000 in kickbacks disguised as payroll payments."
  • Dr. William Steck-"…allegedly referred hundreds of scans to DIA imaging centers and received an estimated amount of $55,000 as compensation from Zuberi shell companies."
  • Dr. Alan Epstein-"...allegedly referred more than 200 scans to Zuberi-owned medical imaging centers. In exchange, Zuberi allegedly paid for architectural services and permits that were meant to expand Epstein's practice, Epstein Chiropractic in Elizabeth.

Not every "perk-payment" is a bad thing for patients, in general. The problem is that the idea, the entire concept, is a double-edged sword, of sorts. At the least, it can be considered a conflict of interest.

So, the next time you're sitting at your doctor's office and see that pharmaceutical representative stroll through the door lugging a suitcase filled with samples behind them, just remember…samples can be a good thing when medications are expensive. The flip side is, you may not be getting those free samples—AND—if you're not getting those free samples, is your clinicians prescribing a higher priced drug in order to receive those "free-samples?"

But if that Rep. is bringing in food, you may want to settle in for a bit—your doctor may be "out-to-lunch" for a while~

Remember—when it comes to health care—if it walks like a duck and quacks like a duck—it's big pharma dropping of the goose that laid the golden egg~

See if your doctor made the Dollars for Docs list~


Other Articles of Interest:

Using Customer Service to Lower Health Insurance Costs: What a Concept!

Obamacare Insurance Premiums Could Increase in 2016

Justice Department Strikes a Blow Against Medicare Fraud

California's Blue-Shield is Singing the Blues


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