Honesty in the medical profession is taught in the context of the doctor-patient relationship. It possibly always has been, it possibly always will be. While the Hippocratic oath does not overtly mention honesty, Vaidya's oath and the Oath of Asaph do.
However, in the process of this "learning" we discover how to stretch the definition of truth and the justification for blurring the boundaries. We distract by a philosophical narrative of "what is truth?" !
This article at Bioetica, a very good paper on honesty and medical ethics, makes interesting reading ... overt lying is disapproved, but acknowledges the "need" to choose what is said in each circumstance.
"This paper argues for truth in the doctor/patient relationship but not for flat-footed or insensitive communication. The presumption is always for truth and against lying. But the arguments support the need to make humane clinical judgments about what is told, when, how, and how much."
If you are interested in further reading, "Teaching Medical Students to lie" addresses another area where medicos are introduced to the attraction of dishonesty.
Once presented with reasons to be given less than forthcoming with the truth then this will naturally spill over into other areas as a doctor including financial dishonesty.
Add to the mix the cultural imperative for dishonesty in certain cultures (ie. being honest creates a survival disadvantage) then we have in this country a minefield.
The taste of reward for dishonesty is provided by our Australian Medicare system. Bill an item 36 instead of an item 23 (or a 23 instead of a 3) and don't get caught. Bulkbill a removal of a deep foreign body instead of a superficial foreign body and don't get caught. Bulkbill a longer, or deeper laceration repair than reality and don't get caught. Bulkbill for a Chronic disease management plan, or Mental Health care plan when not needed and don't get caught. Do it a few times and you realise how easy it is. If everyone does it, then the HIC computer profiling won't pick it because it compares your activity with your peers.
Once you see you can get away with it, then it spreads further. Locum doctors bill for a few hours they didn't work, a few call backs that didn't happen ... yes it has happened, on at least one verifiable occasion in my recent past experience.
Question is why bother about it ? Why care ?
My assertion is that the funds siphoned off into the pockets of dishonest medical professionals (who quite readily justify their actions in a multitude of articulate contortions) are funds not available for the provision of services needed, but cannot be provided for the lack of resource. Yes, there are other significant reasons for ballooning medical costs, such as the self-interested growth in medical middle management, but this corruption of the medical profession by the loss of personal honesty has contributed, in my opinion, to the demise of medical care.
Meanwhile, we get crap instant coffee at work to save a few cents.
Enjoy !
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