title: Should an academic radiation oncologist be allowed to "opt out" of medicare?
abstract: Federal law permits physicians to "opt out" of Medicare. When a radiation oncologist chooses this option, he or she may neither bill nor collect from Medicare, but may legally attempt to charge and collect what he or she considers the value of services provided to Medicare-eligible patients. Many academic faculty practice plans permit members to opt out. Even if it is permissible for a radiation oncologist to opt out of Medicare, is it appropriate? The question raises significant ethical and economic issues as one attempts to balance the good of the individual faculty member against the good of the clinical faculty as a whole. In this commentary, the authors offer the principal arguments in favor of and against permitting a faculty radiation oncologist to opt out. They conclude by recommending broad faculty oversight over such decisions.
authors.affiliation: School of Medicine, Duke University Medical Center, Durham, NC 27710, USA. halpe001@mc.duke.edu
authors.forename: Edward C
authors.initials: EC
authors.lastname: Halperin
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulkerson
authors.forename: Russel
authors.initials: R
authors.lastname: Kaufman
authors.forename: Paul
authors.initials: P
authors.lastname: Newman
authors.forename: Gary L
authors.initials: GL
authors.lastname: Stiles
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005180:Faculty, Medical / Q000592:standards*; D018588:Fee-for-Service Plans; D017048:Health Care Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D015442:Medicare Assignment; D018584:Physician Self-Referral / Q000941:ethics / Q000706:statistics & numerical data*; D011216:Practice Management, Medical / Q000191:economics* / Q000941:ethics; D018787:Radiation Oncology / Q000191:economics* / Q000941:ethics; D014481:United States