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Original Articles

Blessed be the tie that binds? Antitrust perils of physician investment and self‐referral

Pages 359-412 | Published online: 23 Jul 2009

  • Starr , P. 1982 . The Social Transformation of American Medicine
  • Kusserow . 1989 . Financial Arrangements Between Physicians and Health Care Businesses: Report to Congress , (Pub. No. OA1–12–88–0140 1 – 2 . Department of Health and Human Services .
  • Stout . 1991 . Physicians’ Practice of Self‐Referral Disapproved by AMA Ethics Panel . Wall St. J. , Dec. 10 : B‐4
  • II State of Florida Health Care Cost Containment Board . Sept. 1991 . Joint Ventures Among Health Care Providers in Florida Sept. ,
  • Mitchell and Scott . 1992 . New Evidence of the Prevalence and Scope of Physician Joint Ventures . J.A.M.A. , 268 : 880
  • Iglehart . 1991 . Efforts to Address the Problem of Physician Self‐Referral . New Eng. J. Med. , 325 : 1820
  • Uhlik . 1992 . The Truth About Physician Investments . Internist , 33 (8) : 35
  • White . 1991 . Where Business Has Turned Against Doctors . Med. Econ. , 69 (19) : 52
  • Mitchell and Scott . 1992 . Physician Ownership of Physical Therapy Services: Effects on Charges, Utilization, Profits and Quality . J.A.M.A. , 268 : 2055
  • Neels and Finkelstein . 1992 . Physician Self‐Referral: An Analysis of Policy Issues, Available Evidence, and Research Needs , Charles River Associates .
  • Green . 1990 . Medical Joint‐Venturing: An Ethical Perspective . Hastings Center Rep. , 20 (4) : 22
  • Rodwin . 1989 . Physicians’ Conflicts of Interest: The Limitations of Disclosure . New Eng. J. Med. , 321 : 1405
  • Frankford . 1989 . Creating and Dividing the Fruits of Collective Economic Activity: Referrals Among Health Care Providers . Colum. L. Rev. , 89 : 1861
  • Medicare and State Health Care Programs . 1991 . Fraud and Abuse: OIG Anti‐Kickback Provisions . Fed. Reg. , 56 July 29 : 35952
  • Iglehart . 1990 . Congress Moves to Regulate Self‐Referral and Physicians’ Ownership of Clinical Laboratories . New Eng. J. Med. , 322 : 1682
  • Crane . 1992 . The Problem of Physician Self‐Referral Under the Medicare and Medicaid Antikickback Statute: The Hanlester Network Case and the Safe Harbor Regulation . J.A.M.A. , 268 : 85
  • Medicare Program . 1992 . Physician Ownership of, and Referrals to, Health Care Entities that Furnish Clinical Laboratory Service . Fed. Reg. , 57 Mar. 11 : 8588
  • Department of Health and Human Services . 1991 . Medicare, Medicaid, and Clinical Laboratories Improvement Programs: Laboratories Regulations . Fed. Reg. , 57 : 7002
  • McDowell . 1989 . Physician Self‐Referral Arrangements: Legitimate Business or Unethical “Entrepreneurialism,” . Am. J. L. & Med. , 15 : 61
  • Hyman and Williamson . 1988 . Fraud and Abuse: Regulatory Alternatives in a “Competitive” Health Care Era . Loyola U.L.J. , 19 : 1133
  • Kusserow . 1989 . Financial Arrangements Between Physicians and Health Care Businesses: State Laws and Regulations (Management Advisory Report) , (Pub. No. OAI‐12–88–01412 Dep't of Health and Human Services .
  • McCormick . 1992 . Florida Restrictions Include Rate‐Setting Provision . Am. Med. News , Apr. 6 : 1 17 – 18 .
  • Relman . 1980 . The New Medical‐Industrial Complex . New Eng. J. Med. , 303 : 963
  • Relman . 1985 . Dealing with Conflicts of Interest . New Eng. J. Med. , 313 : 749
  • Relman . 1987 . Practicing Medicine in the New Business Climate . New Eng. J. Med. , 316 : 1150
  • Relman . 1991 . The Health Care Industry: Where Is It Taking Us? . New Eng. J. Med. , 325 : 854
  • Council on Ethical and Judicial Affairs . 1992 . Conflicts of Interest: Physician Ownership of Medical Facilities . J.A.M.A. , 267 : 2366 2368
  • Burton . 1992 . Physicians Who Own Labs May Refer Patients to Them for Tests, AMA Says . Wall St. J. , June 24 : B‐6
  • McCorraick . 1992 . AMA Reverses Self‐Referral Stance . Am. Med. News , Dec. 21 : 1 25
  • Morreim . 1989 . Conflicts of Interest: Profits and Problems in Physician Referral . J.A.M.A. , 262 : 390 391
  • McCormick . 1992 . AMA, State Society on Opposite Sides . Am. Med. News , June 1 : 1 17
  • Hamilton . 1992 . Homey Lab Offers Catheterization . The Commercial Appeal (Memphis, Tenn.) , Feb. 16 : C‐3
  • General Accounting Office . July 1991 . Health Care: Antitrust Issues Relating to Physicians and Third‐Party Payers , (GAO HRD‐91–120 July , 1
  • Neuman . 1992 . Medical Ventures Born Out of Need or Profit? . Insight on News , 8 (23) : 12
  • Arquit . Jan. 30 1992 . A New Concern in Health Care Antitrust Enforcement: Acquisition and Exercise of Market Power by Physician Ancillary Joint Ventures , Jan. 30 , Washington, D.C. : National Health Lawyers Association . (prepared remarks delivered to
  • Hillman , Joseph , Mabry , Sunshine , Kennedy and Noether . 1990 . Frequency and Costs of Diagnostic Imaging in Office Practice—A Comparison of Self‐Referring and Radiologist‐Referring Physicians . New Eng. J. Med. , 323 : 1604
  • Hillman , Olson , Griffith , Sunshine , Joseph , Kennedy , Nelson and Bernhardt . 1992 . Physicians’ Utilization and Charges for Outpatient Diagnostic Imaging in a Medicare Population . J.A.M.A. , 268 : 2050
  • 1992 . Campbell Clinic Buys 7.5 Acres . The Commercial Appeal (Memphis, Tenn.) , Oct. 10 : B‐5
  • Morreim . 1990 . Physician Investment and Self‐Referral: Philosophical Analysis of a Contentious Debate . J. Med. & Phil. , 15 : 425
  • Stern . 1983 . Bad Faith Suits: Are They Applicable to Health Maintenance Organizations? . W. Va. L. Rev. , 85 : 911
  • Diamond . 1981 . The Tort of Bad Faith Breach of Contract: When, If At All, Should It Be Extended Beyond Insurance Transactions? . Marq. L. Rev. , 64 : 425
  • Kornblum and Olson . 1986 . California Leads the Way in Bad Faith, But No One Wants to Follow—Recent Trends in California First Party Bad Faith Law . W. St. Univ. L. Rev. , 14 : 37
  • Kapp . 1989 . Enforcing Patient Preferences: Linking Payment for Medical Care to Informed Consent . J.A.M.A. , 261 : 1935
  • Morreim . 1991 . Economic Disclosure and Economic Advocacy . J. Legal Med. , 12 : 275 296 – 301 .
  • DeMott . 1988 . Beyond Metaphor: An Analysis of Fiduciary Obligation . Duke L. J. , : 879
  • Scott . 1949 . The Fiduciary Principle . Cal. L. Rev. , 37 : 439
  • Cooter and Freedman . 1991 . The Fiduciary Relationship: Its Economic Character and Legal Consequences . N.Y. Univ. L. Rev. , 66 : 1045
  • Shepherd , J. 1981 . The Law of Fiduciaries 22 – 23 . 32 35 – 36 . 60 – 61 . 101 225 – 27 . 246
  • Finn , P.D. 1977 . Fiduciary Obligations 78 82 201
  • Holder , A. 1978 . Medical Malpractice Law , 2nd ed. 225
  • Miller . 1983 . “ Secondary Income from Recommended Treatment: Should Fiduciary Principles Constrain Physician Behavior? ” . In The New Health Care for Profit Edited by: Gray , B.H. 153
  • Simon . 1987 . The Psychiatrist as a Fiduciary: Avoiding the Double Agent Role . Psych. Ann. , 17 : 622
  • Fried , C. 1981 . Contract as Promise 94
  • Schaber , G.D. and Rohwer , C.D. 1984 . Contracts , 2nd ed.
  • Keeton , W. , Dobbs , D. , Keeton , R. and Owen , D. 1984 . Prosser and Keeton on Torts , 5th ed. 738 – 39 .
  • Swan . 1945 . The California Law of Malpractice of Physicians, Surgeons, and Dentists . Cal. L. Rev. , 33 : 248 251
  • Meisel . 1988 . A “Dignitary Tort” as a Bridge Between the Idea of Informed Consent and the Law of Informed Consent . Law, Med. & Health Care , 16 : 210
  • Buchanan . 1988 . Principal/Agent Theory and Decision Making in Health Care . Bioethics , 2 : 317
  • Feldman and Ward . 1979 . Psychotherapeutic Injury: Reshaping the Implied Contract as an Alternative to Malpractice . N.C.L. Rev. , 58 : 54 79
  • Mehlman . 1990 . Fiduciary Contracting: Limitations on Bargaining Between Patients and Health Care Providers . Pitt. L. Rev. , 51 : 365
  • Brice . 1989 . Radiologists Often on Losing Side in Fight for Outpatient Imaging . Diagnostic Imaging , 11 (6) : 83
  • Bergman . 1992 . Case Comment: Moore v. Regents of the Univ. of California . Am. J.L. & Med. , 18 : 127
  • Gellhorn , E. 1986 . Antitrust Law and Economics , 3rd ed. 21 – 22 .
  • Kintner , E.W. 1973 . An Antitrust Primer , 2nd ed.
  • Peters and Maneval . 1991 . Medical Staff Credentialing: A Prescription for Reducing Antitrust Liability . Law, Med. & Health Care , 19 : 120 122
  • Sullivan , L.A. 1977 . Handbook of the Law of Antitrust
  • Bloch , R. Nov. 15 1991 . Chief, Professions and Intellectual Property Section, Antitrust Division, Department of Justice, Criminal Antitrust Enforcement and the Health Care Industry, Speech before Practicing Law Institute Nov. 15 , Washington, D.C.
  • Havighurst . 1981 . Competition in Health Services: Overview, Issues and Answers . Vand. L. Rev. , 34 : 1117
  • Rose and Leibenluft . 1986 . Antitrust Implications of Medical Technology Assessment . New Eng. J. Med. , 314 : 1490
  • Costilo . 1985 . Antitrust Enforcement in Health Care: Ten Years After the AMA Suit . New Eng. J. Med. , 313 : 901
  • Havighurst . 1986 . Professional Peer Review and the Antitrust Laws . Case W. Res. L. Rev. , 36 : 1117 1137
  • Furrow , B.R. , Johnson , S.H. , Jost , T.S. and Schwartz , R.L. 1991 . Health Law: Cases, Materials and Problems , 2nd ed. 785 – 882 .
  • Slawson . 1980 . A Stronger, Simpler Tie‐in Doctrine . Antitrust Bull. , 25 : 671 678
  • Baker . 1980 . The Supreme Court and the Per Se Tying Rule: Cutting the Gordian Knot . Va. L. Rev. , 66 : 1235 1238
  • Kaplow . 1985 . Extension of Monopoly Power Through Leverage . Colum. L. Rev. , 85 : 515
  • Craswell . 1982 . Tying Requirements in Competitive Markets: The Consumer Protection Issues . Boston U.L. Rev. , 62 : 661
  • Shaw , G.B. 1911 . The Doctor's Dilemma Vol. 7 ,
  • Magan Medical Clinic . Cal. Rptr. , 57 ( 1 ) 260
  • Berkey . Cal. Rptr. , 82 77 – 78 .
  • Waldholz and Bogidanich . 1989 . Doctor‐Owned Labs Earn Lavish Profits in a Captive Market . Wall St. J. , Mar. 1 : A‐1 A‐6
  • Havighurst . Doctors and Hospitals: An Antitrust Perspective on Traditional Relationships . Duke L. J. , 1984 1071 1142
  • Borsody . 1979 . The Antitrust Laws and the Health Industry . Akron L. Rev. , 12 : 417 424
  • Bowman Jr. 1957 . Tying Arrangements and the Leverage Problem . Yale L. J. , 67 : 19
  • Bork , R. 1978 . The Antitrust Paradox 365 – 81 .
  • Hamilton . 1991 . David Fares Well Among Goliaths . The Commercial Appeal (Memphis, Tenn.) , Apr. 21 : C‐3
  • Hamilton . 1991 . Doctors’ Kidney‐Stone Crusher Zaps Insurers, Patients $7,100 . The Commercial Appeal (Memphis, Tenn.) , June 2 : A‐1 A‐14
  • Hamilton . 1991 . Kidney Machine Attracts Attention . The Commercial Appeal (Memphis, Tenn.) , June 9 : C‐3
  • Hamilton . 1991 . Local Venture Won't Follow New Guidelines . The Commercial Appeal (Memphis, Tenn.) , Aug. 18 : C‐3
  • Hamilton . 1991 . Memo Sees Fortune from Crusher of Kidney Stones . The Commercial Appeal (Memphis, Tenn.) , Aug. 25 : C‐3
  • Hamilton . 1991 . Urologists Expected to Reject Device Tied to Fee Cut . The Commercial Appeal (Memphis, Tenn.) , Sept. 8 : C‐3
  • Hamilton . 1991 . AMA Checks Ethics of Doctors’ Venture . The Commercial Appeal (Memphis, Tenn.) , Sept. 25 : A‐1 A‐15
  • Hamilton . 1991 . Testimony Slated on Lithotripter . The Commercial Appeal (Memphis, Term.) , Oct. 9 : B‐1
  • Hamilton . 1991 . Mid‐South Urologists Drive Treatment Cost Up, Panel Told . The Commercial Appeal (Memphis, Tenn.) , Oct. 18 : A‐7
  • Hamilton . 1991 . Legislators Quiz Doctors’ Lock on Kidney Therapy . The Commercial Appeal (Memphis, Term.) , Nov. 19 : A‐1 A‐15
  • Posner . 1974 . Exclusionary Practices and the Antitrust Laws . U. Chi. L. Rev. , 41 : 506 534
  • Stoeckle and Reiser . 1992 . The Corporate Organization of Hospital Work: Balancing Professional and Administrative Responsibilities . Annals Internal Med. , 116 : 407 409
  • Leibenluft and Pollard . 1981 . Antitrust Scrutiny of the Health Professions: Developing a Framework for Assessing Private Restraints . Vand. L. Rev. , 34 : 927
  • Council on Ethical and Judicial Affairs of the American Medical Association . 1991 . Gifts to Physicians from the Pharmaceutical Industry . J.A.M.A. , 265 : 501
  • Chren , Landefeld and Murray . 1989 . Doctors, Drug Companies, and Gifts . J.A.M.A. , 262 : 3448
  • Melski . 1992 . Price of Technology: A Blind Spot . J.A.M.A. , 267 : 1516
  • Eddy . 1990 . What Do We Do About Costs? . J.A.M.A. , 264 : 1161
  • Butler and Haislmaier . 1989 . Critical Issues: A National Health System for America .
  • Reiser . 1992 . Consumer Competence and the Reform of American Health Care . J.A.M.A. , 267 : 1511
  • Marmor , Boyer and Greenberg . 1981 . Medical Care and Procompetitive Reform . Vand. L. Rev. , 34 : 1003 1008
  • Moffit . 1992 . Surprise! A Government Health Plan that Works . Wall St. J. , Apr. 2 : A‐14
  • Havighurst . 1990 . Practice Guidelines for Medical Care: The Policy Rationale . St. Louis U.L. J. , 34 : 777
  • Kalb . 1990 . Controlling Health Care Costs by Controlling Technology: A Private Contractual Approach . Yale L. J. , 99 : 1089
  • Professor, Department of Human Values and Ethics, College of Medicine, University of Tennessee. Address correspondence to Professor Morreim at Department of Human Values and Ethics, 956 Court, Suite B328, Memphis, TN 38163. The author acknowledges with gratitude the very helpful criticisms and comments provided on earlier drafts of this article by Clark Havighurst, J.D., Lawrence Pivnick, J.D., Roy Spece, Jr., J.D., and Lance Stell, Ph.D.

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