Why is patient brokering, in the form of paying a referral, illegal?
Because, as a matter of public health policy, we want citizens making their own healthcare choices, without unreasonable influence or inducement.
We want our healthcare practitioners to endeavor to provide the highest quality of care and service based upon education, experience, and earned reputation.
If a healthcare provider can simply pay for a referral, then we make the reasonable assumption he/she need not worry about endeavoring to provide the very best in healthcare, because they are obtaining patients through paid referrals, rather than on their reputation for quality of care.
As a result, the theory continues, the quality of care will decline because a provider who can buy patients need not worry about reputation or outcomes. They just need pay a referral source.
While there are a multitude of other evils about patient brokering which are beyond the scope of this specific article (the best of which has been written by the Post’s John Pacenti), the issue remains – we need to find a legitimate way to connect patients with providers.
As of today, I simply do not know of any legitimate way that currently exists, with the exception being good old-fashioned, actual one-on-one human interaction, including a robust alumni program, and traditional advertising.
However, in the meantime, we can only prosecute our way through this, and there will be collateral damage. But once all “patient brokers” have been removed from the streets, know that all that will be left are those with the largest ad budgets who can afford to do the most expensive ad campaigns.
And when that happens, the social policy behind patient brokering will still remain equally violated – a patient will still be unable to make a fair and informed healthcare decision for themselves (or, more often, on their behalf by their loved one) since there will only be “one” game in town – he who can outspend his competitors in the Google Ad and SEO (search engine optimization) space.
In other words, without addiction treatment advertising “parity”, the entity who “screams the loudest” and most frequently will be the only voice heard.
As a result, the same evil will remain – there will still be no need by those limited providers to concentrate on quality of care, since they will have eliminated all competition by cornering the information accessibility marketplace. The more sophisticated providers who pay for flashy internet ad campaigns and well-conceived logarithms to identity similarly needy addicts are not going to automatically transform into ethical and effective healthcare providers.
Stated otherwise, good healthcare and paying for referrals are not automatically mutually exclusive.
Once we have removed the “broker” from the equation, by continuing to allow the patient to choose their addiction treatment provider by a method other than the legitimately earned and qualified reputation of the program and its owners and clinicians, we have simply replaced the street thug with a business suit.
I therefore applaud the Office of the State Attorney for Palm Beach County (Florida), the Honorable Dave Aronberg, and his staff, for understanding this modern-day and unforeseeable Hobson’s Choice, and for supporting “truth in advertising” marketing regulations that start the process of bringing transparency to an industry that has been ignored far too long when it comes to providing sensible guidelines to allow private providers to meet market demand while concurrently continuing to protect the public.
In the interim, I do understand and can often empathize with the frustrations of an industry sector that, unlike its medical healthcare counterparts, has been told to go and solve the country’s addiction epidemic, but has been hypocritically criticized for doing so in a for-profit business model.
Meanwhile, as the battle rages on between the treatment industry and the recovery community for the best way to “save the soul” of the afflicted, we have an epidemic to address and an industry that hires thousands of people who actually care about positive sustainable outcomes and the long-term healing of our nation.
Rather than paint them all with a broad brush of negativity, let’s start to focus (and report) on all the good they are doing, one day at a time.
Note: The article by John Pacenti of the Palm Beach Post is a great read and can be found here.
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