In his testimony the physician conceded that reduction in referrals to medical specialists increased the income to his medical group. The jury found for the plaintiff. As with other ethical issues in medicine, there is no consensus on the meaning of this important case. From a number of similar cases, however, it seems apparent that some juries have a clear perception of the physician's ethical fiduciary responsibility. Such decisions suggest that juries are unlikely to accept incentives designed to restrict a patient's access to appropriate care when that decision violates patient autonomy and results in an adverse patient outcome.
Physicians also face powerful disincentives.
These negative incentives include termination without a defined cause or due process. Personal financial incentives and disincentives threaten multiple ethical principles, and create conflicts of interest and moral dilemmas. It should be pointed out that not all financial incentives are adverse to patient care. For instance, incentives can be structured so that the revenues they create are reinvested in other aspects of care, e.g., better medical equipment or medical libraries. When employed, therefore, financial incentives should be oriented toward reducing costs and improving quality of care.