ABFAS Professional Ethics and Standards 2 — Questions and Answers
Question 1: A podiatric surgeon discovers that a colleague is routinely performing unnecessary procedures to increase billing revenue. What is the most ethically appropriate first step?
- Immediately report to the state medical board without any discussion
- Confront the colleague directly and privately to address the concern (Correct answer)
- Ignore the behavior since it does not affect your own practice
- Report anonymously to the hospital billing department only
Correct answer: Confront the colleague directly and privately to address the concern
Ethical standards generally require addressing concerns with a colleague directly first before escalating to formal reporting bodies.
Question 2: Under ABFAS ethical guidelines, which situation would constitute an inappropriate financial relationship with a referring physician?
- Co-authoring a peer-reviewed research article
- Paying a referring physician a per-referral fee (Correct answer)
- Sharing call coverage on a rotating schedule
- Attending a professionally sponsored CME event together
Correct answer: Paying a referring physician a per-referral fee
Fee-splitting or paying per-referral fees to referring physicians violates anti-kickback statutes and ABFAS ethical standards.
Question 3: A board-certified foot and ankle surgeon is asked to provide expert witness testimony in a malpractice case. Which ethical obligation applies?
- Testify only if retained by the defense side
- Provide honest, objective testimony regardless of who retained them (Correct answer)
- Decline all expert witness roles to avoid conflicts of interest
- Adjust testimony to favor the outcome that benefits the profession
Correct answer: Provide honest, objective testimony regardless of who retained them
Expert witnesses have an ethical duty to provide truthful, unbiased testimony based on evidence and professional standards.
Question 4: When a patient requests copies of their medical records, an ABFAS-certified surgeon must comply within what general ethical framework?
- Deny records until all outstanding balances are paid
- Provide records promptly while protecting third-party information (Correct answer)
- Require a court order before releasing any records
- Charge fees high enough to discourage unnecessary requests
Correct answer: Provide records promptly while protecting third-party information
Patients have a right to their medical records, and ethical practice requires prompt release while protecting others' privacy.
Question 5: A foot and ankle surgeon learns that their ABFAS board certification has lapsed. The most ethical course of action is to:
- Continue practicing and renew at next opportunity without disclosure
- Cease using the ABFAS designation and promptly begin the recertification process (Correct answer)
- Inform only hospital credentialing but not patients
- Apply for an emergency waiver while continuing to advertise certification
Correct answer: Cease using the ABFAS designation and promptly begin the recertification process
Using a lapsed certification designation constitutes misrepresentation; surgeons must stop using it and pursue recertification.
Question 6: Which principle of biomedical ethics requires a foot and ankle surgeon to act in the patient's best interest, even when it conflicts with the surgeon's financial benefit?
- Autonomy
- Justice
- Beneficence (Correct answer)
- Nonmaleficence
Correct answer: Beneficence
Beneficence obligates practitioners to promote the well-being of their patients above personal gain.
Question 7: A surgeon receives a gift valued at $500 from a medical device company whose implants they frequently use. This situation most likely represents:
- An acceptable token of appreciation with no ethical implications
- A potential conflict of interest that should be disclosed or avoided (Correct answer)
- A standard industry practice explicitly approved by ABFAS
- A reportable criminal offense requiring immediate legal counsel
Correct answer: A potential conflict of interest that should be disclosed or avoided
Gifts from device or pharmaceutical companies can create conflicts of interest and must be disclosed or avoided per ethical guidelines.
ABFAS Professional Ethics and Standards 2
A podiatric surgeon discovers that a colleague is routinely performing unnecessary procedures to increase billing revenue.
What is the most ethically appropriate first step?