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Surgical Co-Management

Such arrangements should be made only to ensure the highest quality of care.
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Code of Medical Ethics Opinion 2.3.6

Surgical co-management refers to the practice of allotting specific responsibilities of patient care to designated clinicians. Such arrangements should be made only to ensure the highest quality of care.

When engaging in this practice, physicians should:

(a) Allocate responsibilities among physicians and other clinicians according to each individual's expertise and qualifications.

(b) Work with the patient and family to designate one physician to be responsible for ensuring that care is delivered in a coordinated and appropriate manner.

(c) Participate in the provision of care by communicating with the coordinating physician and encouraging other members of the care team to do the same.

(d) Obtain patient consent for the surgical co-management arrangement of care, including disclosing significant aspects of the arrangement such as qualifications of clinicians, services each clinician will provide, and billing arrangement.

(e) Obtain informed consent for medical services in keeping with ethics guidance, including provision of all relevant medical facts.

(f) Employ appropriate safeguards to protect patient confidentiality.

(g) Ensure that surgical co-management arrangements are in keeping with ethical and legal restrictions.

(h) Engage another caregiver based on that caregiver’s skill and ability to meet the patient’s needs, not in the expectation of reciprocal referrals or other self-serving reasons, in keeping with ethics guidance on consultation and referrals.

(i) Refrain from participating in unethical or illegal financial agreements, such as fee-splitting.

AMA Principles of Medical Ethics: I, II, IV, V, VI

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