When your doctor orders you to go for a private medical test, ask to see his stocks portfolio.
The latest scam rocking the American health industry, disclosed on an 17 October House of Representatives Ways and Means Committee hearing, concerns the large number of doctors who own shares in treatment and diagnostic facilities to which they send patients and thereby benefit financially.
Although no one knows the extent of these arrangements, euphemistically known as "joint ventures", they are definitely on the rise in the States. According to The Lancet, which reported on the hearing testimony, 10,000 of the 18,250 doctors involved in direct patient care in Florida were identified as "owners of health care facilities."
Although organizations like the American Academy of Neurology argued that the quality of testing would be higher in physician owned centers", the committee heard copious evidence to suggest that, in the main, patients were being unnecessarily over tested by doctors who stood to gain with each body that passed through his facility's door.
One study showed that patients sent to doctor owned facilities had nearly 50 per cent more treatments than those not sent to "joint venture" testing sites. Another found that that doctor owned labs performed 3.3 tests per patient, compared with 1.7 tests per patient by independent labs.
Among the more outlandish deals reported to the committee was the testimony of a company called Health Images, which operates 30 magnetic resonance imaging centres around the States. One group of orthopaedic doctors offered to send some 300 patients a month if Health Images would in turn arrange for all expenses paid holidays to Mexico for the group's partners.
Many of the abuses could be made illegal by a new set of regulations being prepared by the US Department of Health and Human Services for doctors in businesses that receive Medicare payments.
But as the Lancet points out, most are already proscribed either specifically by law or by ethical code of practice, and nonetheless have thrived.