Financial Boundaries with Patients
Society in general holds physicians in a unique position. Their opinions are generally well respected and placed in a position of trust. There are times when patients approach physicians with business opportunities, either to invest funds in a project, in trade for services, or as a side-business. Such a financial relationship is not a per se ethical violation; however, there are ethical concerns and pitfalls.
The AMA states that under no circumstances may a physician place their own financial interests above the welfare of their patients. The purpose of this section specifically discusses performing unnecessary medical care for financial gain, but this flows in financial entanglements with patients. There is the potential for abuse for both the patient and the physician to harm each in the blending the relationship.
There is no statute that forbids economic relationships between a physician and patient. However, the Board as proffered a guideline suggesting that in some circumstances, such a relationship is a violation of the Medical Practice Act. Specifically, 22 Texas Administrative Code §190.1(c)(2)(G), states that it is unprofessional conduct when a physician becoming financially or personally involved with a patient in an inappropriate manner.
The question is what constitutes an “inappropriate manner?” In my professional opinion means any activity that does or reasonably could compromise the professional boundary between the patient and physician.