Buy A Patient, Lose Your License

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Medical marketers are selling patients and the cost for California doctors could be a $50,000 fine, or prison time.

In the competitive world of elective healthcare access to potential patients is invaluable. So what doctor wouldn’t jump at the chance to buy guaranteed patient referrals from a legitimate medical marketing firm? Any doctor who doesn’t want to spend a year reading Plastic Surgery News from behind bars.

An emerging trend in medical marketing treats patients like commodities and puts medical professionals in serious legal peril. Pay per lead programs, a popular form of online affiliate marketing, are popping up like weeds in the elective healthcare industry. These programs charge a set fee for the name and contact information of a patient interested in a specific procedure. According to the Medical Board of California such programs are a clear violation of Section 650 of the Business and Professions Code, and similar codes exist in many states. Across the nation, hundreds of surgeons have been lured in to the unethical practice of “fee for referral.”

The way Section 650 is written, it’s no wonder medical professionals might be confused about the legality of participating in pay-per-lead programs.

    650. Except as provided in Chapter 2.3 (commencing with Section 1400) of Division 2 of the Health and Safety Code, the offer, delivery, receipt, or acceptance by any person licensed under this division or the Chiropractic Initiative Act of any rebate, refund, commission, preference, patronage dividend, discount, or other consideration, whether in the form of money or otherwise, as compensation or inducement for referring patients, clients, or customers to any person, irrespective of any membership, proprietary interest or co-ownership in or with any person to whom these patients, clients, or customers are referred is unlawful.

When you cut through the legalese, the message is clear, “...the offer...of compensation or inducement for referring unlawful.”

It is the kind of unlawful conduct that can land a doctor in prison or with fines up to $50,000 on the first offense. According to a representative of the Medical Board of California, all of the California surgeons participating at have already been sent notice of their violation.

According to Ryan Miller, President of the medical marketing consultancy Etna Interactive (, “Even savvy doctors are unsure how to apply section 650 to their medical marketing decisions. With the doctor’s medical license on the line, we recommend the most conservative interpretation.”

Miller reports, “We’ve guided our clients away from these programs for years. But we were alarmed when we received three calls from California plastic surgeons shopping for pay-per-lead services in just one week. It’s evident that many California doctors need clarification on the implications of section 650 of the business & professions code before they find themselves in front of a review board.”

About Etna Interactive:

Founded in 2002, and based in San Luis Obispo, California, Etna Interactive provides Web marketing services to the elective healthcare industry (including medical device manufacturers, plastic surgeons, cosmetic surgeons, cosmetic dentists and medical day spas); to physicians and surgeons offering new or novel treatments; and to professional service providers including lawyers, architects and builders. Etna Interactive services clients from Hawaii to upstate New York.


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