Genovese Elizabeth
University of Pennsylvania Medical Center, Philadelphia, USA.
Clin Occup Environ Med. 2004 May;4(2):viii, 361-72. doi: 10.1016/j.coem.2004.02.005.
Some individuals in the health care system base their actions primarily on individual economic incentives rather than ethical and societal standards. These actions are considered fraudulent when they can be proven to have violated specific laws or statutes and can impact workers' compensation costs. Physicians and other health care providers involved in the management of workers' compensation claims may have little ability to affect employer or insurer fraud. Ethical and efficient practice style, in conjunction with the maintenance of clarity and objectivity in the evaluation of patient symptoms, can help to reduce the degree to which provider and patient fraud is allowed to develop and flourish. In understanding the factors that promote fraudulent behavior and being able to recognize and manage such behavior, health care providers may impact the perpetuation of fraud and its impact on the workers' compensation system.
医疗保健系统中的一些人主要依据个人经济激励而非道德和社会标准来采取行动。当这些行为被证明违反了特定法律或法规并可能影响工伤赔偿成本时,就被视为欺诈行为。参与工伤赔偿索赔管理的医生和其他医疗保健提供者可能几乎没有能力影响雇主或保险公司的欺诈行为。道德且高效的执业方式,再加上在评估患者症状时保持清晰和客观,有助于减少医疗保健提供者和患者欺诈行为的滋生和泛滥程度。在了解促进欺诈行为的因素并能够识别和管理此类行为方面,医疗保健提供者可能会影响欺诈行为的持续存在及其对工伤赔偿系统的影响。