September 1, 2012



I have a long standing patient who is a lawyer. I have her on narcotic medications for pain. Her partner (a personal injury attorney) wants to refer patients to me. My patient will have no influence on the referrals as she is a contract attorney and not a personal injury attorney.

Is there a conflict of interest?




This is actually a pretty loaded question because the answer is entirely dependent upon the actual circumstances surrounding the relationships. Hypothetically speaking, if the patient does not receive any special treatment, and the referrals by the patient's partner are not tied with any benefit - no remuneration in exchange for the referrals (otherwise known as a "kickback") then receiving referrals from the patient association should not raise any red flags. However, should these circumstances vary, and should you decide to provide your patient with any benefit as a result of the new referral stream, for, by example, begin to waive co-payment amounts, that special treatment would amount to remuneration and potentially be considered an illegal kickback. Similarly, should the referrals be contingent upon benefits to the personal injury attorney, for example, cash payments or less than proper diagnoses for those referred to benefit the attorney's clients, there may also be enormous liability disclosure. So, by the mere fact that your patient is associated with a potential referral source, does not a prohibited referral make. However, should you be sharing or receiving a prohibited benefit because of the referrals, you may be opening yourself and your practice up to enormous liability.

Had this question been precipitated by the possibility that the personal injury lawyer will be expecting a quid pro quo, my advise is to pass on the "opportunity", which would potentially amount to more trouble than it may be worth.

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