Sinners and Saints: Medical Business Ethics in Interventional Radiology

Medical business ethics are the ethical principles and values that guide the conduct of business in healthcare.[1] Medicine is unique in the business sense because people tend to believe that patient outcomes should be the primary focus over monetary gains, such that a less lucrative course should be taken if it is better for the patient.[2] In interventional radiology (IR), concerns regarding medical business ethics often surround the relationships between IRs and industry partners, competition among providers, and other situations where there is lack of alignment between motivations to do what is best for one's patients, one's practice, and personal gains.

Often business and clinical motivations align. Good business practices can facilitate better healthcare for more people, and good clinical care is critical to a successful practice and healthcare organization. Issues arise when our commitment to patients, our practice, and ourselves conflict, so that one may be willing to undermine patient care for personal gains, financial or otherwise.[3] Discussions of these tensions can fall victim to a false dichotomy, particularly in popular media, where clinicians are either painted as altruistic saints only devoted to the welfare of their patients or selfish sinners in cahoots with industry and big pharma.[4] In reality, most clinicians possess a complex blend of selfless and selfish motivations. There is nothing unethical about wanting to have a successful career or make more money for oneself and one's family. However, these sincere motivations can lead to unethical behavior when they are prioritized over patient welfare.

IRs should adhere to the highest medical business ethics standards to both ensure the best care for patients and to maintain the trust of the public. To ensure these ethical standards are met, it is important for IRs to be aware of the ethical issues that commonly arise in practice, have a roadmap for navigating these challenges, and create an open dialogue to seek guidance when needed. The following cases will illustrate these issues and lessons.

Publication History

Article published online:
04 May 2023

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