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Ethical issues in dermatopathology

机译：皮肤病理学中的伦理问题

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Some of the most contentious and relevant ethical issues in dermatopathology include client billing, the practice of dermatopathology by physicians without board certification in dermatopathology, and the practice of including recommendations regarding further surgery in dermatopathology reports. Client billing is a system in which clinicians directly compensate laboratories for pathology services and directly bill patients and/or third-party payers. Although proponents argue that this system can reduce health care costs and increase efficiency, others have argued that it creates an environment that fosters unethical, and potentially illegal, behavior. The development of various types of laboratory models, commonly referred to as "contractual joint ventures," has served to expand client billing. Although the field of dermatopathology is considered a subspecialty of both clinical dermatology and anatomic pathology, dermatopathology is commonly practiced by clinical dermatologists and general anatomic pathologists who are not board certified in dermatopathology. Although these physicians are legally entitled to practice dermatopathology, some have questioned the ethics of this situation, especially when board-certified dermatopathologists are available. Finally, dermatopathology reports, on occasion, include suggestions regarding the need for additional surgery or other clinical courses of action. Although established guidelines do not fully endorse or discourage this practice, various opinions exist regarding its affect on patient care.
机译：皮肤病理学中最有争议和相关的伦理问题包括：客户开票，未经皮肤病理学专业委员会认证的医师进行皮肤病理学的做法，以及在皮肤病理学报告中包括有关进一步手术的建议的做法。客户计费是一种系统，在该系统中，临床医生直接为实验室提供病理学服务补偿，并直接向患者和/或第三方付款人计费。尽管支持者认为该系统可以降低医疗保健成本并提高效率，但其他人则认为，该系统营造了一种助长不道德甚至潜在违法行为的环境。各种类型的实验室模型（通常称为“合同合资企业”）的发展有助于扩大客户的账单。尽管皮肤病理学领域被认为是临床皮肤病学和解剖病理学的一个专业，但皮肤病病理学通常是由未经皮肤病学认证的临床皮肤病学家和一般解剖病理学家进行的。尽管这些医生在法律上有权从事皮肤病理学研究，但有些人对这种情况的伦理学提出了质疑，尤其是当有董事会认证的皮肤病理学家在场时。最后，皮肤病理学报告有时会包括有关需要额外手术或其他临床行动过程的建议。尽管既定的准则并未完全认可或劝阻这种做法，但对于其对患者护理的影响，存在各种意见。

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