Hippocratic Economics (the Physician's Dilemma)

The nature of the medical profession puts physicians in an unusual position. Patients seek out physicians' help because of their expertise in dealing with illnesses, possibly even life-threatening ones. The asymmetry of knowledge in this relationship, the expert physician and the inexpert patient, creates an ethical dilemma for physicians regarding the delivery of care. Physicians determine how much care to offer while receiving remuneration for this care. Here, acting as patients' agents, physicians have immense discretionary power not only with patients' health but also with their pocketbooks. Known as the principal-agency problem, this type of relationship is part and parcel of what business scholars refer to as moral hazard. This article explains the problem of moral hazard and how it affects radiologists and places it in the context of professional and ethical behavior. Its causes and relationship to human nature are explored. The consequences of falling prey to moral hazard in the practice of radiology are discussed.