What is difficult to control, however (and extremely difficult to train salespeople to penetrate), is the political referral that clearly falls within the category of an expected quid pro quo: I will send you my scans if you give me something in return.Kauffman-Pickelle goes on to describe the ways in which unscrupulous operators will go around the law and regulations trying to bribe their way into a full schedule. He goes on to say,
This is of course very good advice, and an excellent analysis. I would carry it over to the problem of imaging self-referral, which is really the same sort of greed-based pursuit of money as described above.
Back to the fundamental question: How do you compete with this greed?
You don’t. Greed is as old as civilization itself, and money—as a manifestation of this one of the seven deadly sins—has been changing behavior and sinking people for centuries.
What ethical and honest businesses need to do is rise above the temptation, knowing that those operating sleazy businesses are really in the minority and that they stand a very good chance of being caught and punished; they are not likely to be happy with themselves and their lives, and are not respected members of the medical community. You need to be able to look at yourself in the mirror each day and know that you are helping people, running a clean and effective operation, and inspiring your staff and teammates to achieve success through your leadership. Your ethics, values, and character will win in the long term.
This is good business as well. Never apologize for your success or for making a good living at your chosen craft. You have earned it, and our society is based on the hard work and commitment of entrepreneurs in all kinds of professions, including medical imaging. Don’t be distracted by those who seem to be getting away with illegal behavior. You really would not want to trade places with them, so leave them to their own devices.
Mr. Kauffman-Pickelle's approach makes sense for those who are of high moral and ethical fiber. Naturally, they are not going to lower themselves to borderline or overtly illegal activities to make an extra dollar. Sadly, those who do participate probably don't care. I would have to disagree with the author about the perpetrators being unhappy and not respected in the community, at least as far as physician self-referrers are concerned. They are happy as clams, wallowing in their ill-gotten gains. They feel completely immune from penalty, that they deserve every cent. Very few of their colleagues care about the source of the revenue in the least; they are only envious of the parade of Mercedes and BMWs and the other swag flaunted by those who abuse the system.
This is why the government will eventually have to step in; there isn't much self-policing going on here. The politics of greed rule.