Cost containment and medical judgment.

A physician should not allow financial criteria to influence his decision to discharge a patient from the hospital despite pressures that may exist to do so. If injury to the patient is attributable to a premature discharge approved by a physician, the physician can expect to be held accountable. Under Wickline, a physician should protest to a third-party payor whose prospective utilization review decision would result in the withholding of necessary medical care. Such protests should be documented. Where a patient requires continued hospitalization, it would be advisable to so inform the patient and the hospital administrator so that arrangements for care in an appropriate facility can be made.