Moral issues and beliefs about money

[sonny_1080]

If you had a list of doctors that had the cure for cancer, and people were calling you to be connected with those doctors.

But some doctors are terrible, others great, and everything in between.

And you were in position to have a referral program to these doctors, but if the good ones did not join your referral program, then you would not send people to them.

And you could possibly be seen as someone "in it for the money" or unethical because your decision to refer people is based off money.

How would you handle that situation?

 

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[Sethamus]

Have those doctors listed along with the others, but doctors who have paid as the forefront. Still giving people options to find the good ones, but providing value to your customers who paid.

 

[sonny_1080]

Have those doctors listed along with the others, but doctors who have paid as the forefront. Still giving people options to find the good ones, but providing value to your customers who paid.

I should’ve specified this: the business model is “call and we’ll connect you with these doctors”

If that wasn’t the model, then your solution would make good sense. But since it isn’t a “paid listing service” and more of a pay per lead service, it changes things.

 

[Speed112]

because your decision to refer people is based off money.

Every decision to do everything is "based off money" or, at the very least, has money as part of the equation. Whenever you choose to act in any way, you are naturally discarding the option to act in other ways. When you pay $5 to buy a t-shirt, you no longer have $5 that you could use to buy a cup of coffee.

So people who claim "you're in it for the money" are silly and you should ignore them.

If you are providing a valuable service, you are doing so while investing your precious time and resources. In the process, you're blocking yourself from using those in other ways. So it's perfectly natural to expect to be compensated.

Are you running a charity or a business?

It actually doesn't even matter, because even charities are compensated for their work, and donations are used to cover people's expenses and reward them for their efforts.

So personally, I wouldn't handle that situation, because to me the situation is absurd. Some silly people believe silly things about me. I don't care. Those who understand reality will use my valuable service, while those who don't are going to suffer. Because the service helps THEM more than it helps me.

Leads are valuable. You charge them for the leads. If you cannot reach an agreement with people so that they can be listed within YOUR property, through YOUR labor, so that they can get the value that YOU provide, then sucks to be them. They are not entitled to your work, time, property, or service. They are not entitled to exposure within your virtual real-estate. Not including them in your list does not mean you're withholding options from your audience. You're still giving them more options than they previously had. They still gain.

So don't sweat it so much.

As long as you're not claiming that X and Y are the two best options in the world, while you know there is a Z who is better than them but hasn't agreed to your terms, you are not doing anything unethical.

If you still have moral qualms, though... You could have the audience foot the bill. So for example, you have your partners who have opted to be listed and agreed to the lead-gen fee, then their info is available for the prospects so they can connect.

Then you can still list the "better options" next to them, as long as their info is public, and say that their contact details are locked because they are not partnered, and they can be unlocked for money, or at request if the doctor ends up agreeing to your terms. You can use the market interest as leverage to get them on board.

Information isn't free and people aren't entitled for it. If they get emotional and say stuff like "How dare you ask me for $50 to introduce me to a doctor? My daughter is dying of cancer!" that's their problem. If they said the same thing to a doctor who charges them for medicine they'd be just as silly. You're not being subsidized by taxpayers, so why should you service people for free?

Lying, cheating, harming people, etc. are unethical. Charging people for a service that has cost you time and money is not unethical, because had you not started with the expectation of being able to charge for it, you would not have built the service in the first place. So they're trading $0 for No service with $X for Some service. Saying no to that costs them nothing. Saying yes to it gains them something (if the value exchange is sound).

It's morally virtuous. Commerce is great. Go help people with it.

 

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[sonny_1080]

Every decision to do everything is "based off money" or, at the very least, has money as part of the equation. Whenever you choose to act in any way, you are naturally discarding the option to act in other ways. When you pay $5 to buy a t-shirt, you no longer have $5 that you could use to buy a cup of coffee.

So people who claim "you're in it for the money" are silly and you should ignore them.

If you are providing a valuable service, you are doing so while investing your precious time and resources. In the process, you're blocking yourself from using those in other ways. So it's perfectly natural to expect to be compensated.

Are you running a charity or a business?

It actually doesn't even matter, because even charities are compensated for their work, and donations are used to cover people's expenses and reward them for their efforts.

So personally, I wouldn't handle that situation, because to me the situation is absurd. Some silly people believe silly things about me. I don't care. Those who understand reality will use my valuable service, while those who don't are going to suffer. Because the service helps THEM more than it helps me.

Leads are valuable. You charge them for the leads. If you cannot reach an agreement with people so that they can be listed within YOUR property, through YOUR labor, so that they can get the value that YOU provide, then sucks to be them. They are not entitled to your work, time, property, or service. They are not entitled to exposure within your virtual real-estate. Not including them in your list does not mean you're withholding options from your audience. You're still giving them more options than they previously had. They still gain.

So don't sweat it so much.

As long as you're not claiming that X and Y are the two best options in the world, while you know there is a Z who is better than them but hasn't agreed to your terms, you are not doing anything unethical.

If you still have moral qualms, though... You could have the audience foot the bill. So for example, you have your partners who have opted to be listed and agreed to the lead-gen fee, then their info is available for the prospects so they can connect.

Then you can still list the "better options" next to them, as long as their info is public, and say that their contact details are locked because they are not partnered, and they can be unlocked for money, or at request if the doctor ends up agreeing to your terms. You can use the market interest as leverage to get them on board.

Information isn't free and people aren't entitled for it. If they get emotional and say stuff like "How dare you ask me for $50 to introduce me to a doctor? My daughter is dying of cancer!" that's their problem. If they said the same thing to a doctor who charges them for medicine they'd be just as silly. You're not being subsidized by taxpayers, so why should you service people for free?

Lying, cheating, harming people, etc. are unethical. Charging people for a service that has cost you time and money is not unethical, because had you not started with the expectation of being able to charge for it, you would not have built the service in the first place. So they're trading $0 for No service with $X for Some service. Saying no to that costs them nothing. Saying yes to it gains them something (if the value exchange is sound).

It's morally virtuous. Commerce is great. Go help people with it.

Oh man. Thank you thank you thank you.

 

[Odysseus M Jones]

Oh man. Thank you thank you thank you.

Now you're over that dilemma.

But some doctors are terrible

Will you send dying people to them?


Now I think about it, this is like playing God.


But seriously, how do you decide which doctor to send customers to?

It seems you're using your personal bias to decide who gets the business.


In this instance, how can you know who's good & who's terrible?

You won't have personally used every doctor, especially for cancer treatments.

You going on reviews?


Of course this is all moot, a doctor with a cure for cancer doesn't need your service, they just need a reporter.


But on the subject of pay per appointment.

It seems that only the lesser businesses need this kind of service.

The good ones are productocracies, they won't use you.

 

[sonny_1080]

You going on reviews?

I made a review website, yes.

If there are a bunch of doctors in the area that range from completely unscrupulous to totally virtuous, and everything in between, there is obviously a shop-ability problem.

Not to mention the fact that a lot of people don't know which is which until they go there and check out each place.

So now I made a review site for people to hopefully solve this shop-ability problem.

However, reviews aren't happening as fast as I expected. Less reviews = no incentive for doctors to engage with the audience = no revenue from doctors engaging with the audience.

BUT... people are randomly reaching out to me on Facebook looking for a doctor that fits their specific needs (because apparently everybody has there own specific needs and doctors are positioned differently to cater to some needs and not others).

My thinking is... I'll just charge these doctors to send them people.

Now you're over that dilemma.


Will you send dying people to them?


Now I think about it, this is like playing God.


But seriously, how do you decide which doctor to send customers to?

It seems you're using your personal bias to decide who gets the business.


In this instance, how can you know who's good & who's terrible?

These are great questions that I'm still trying to answer.

There is a coalition of doctors that are "certified" and pre-vetted so I can only work with them.

However, there's a lot of doctors that aren't certified by this coalition that are also recommendable.

Then there is the places that are just completely toxic and harmful.

My review site helps. The coalition helps. But in the end of the day, people just need the help urgently. So I figure if I can give them a place to go that's not completely toxic and harmful then their problem is solved.

But, this attitude will be seen by the coalition and people in that network as unscrupulous and "in it for the money" as I mentioned earlier.

 

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[Sethamus]

Are you reaching out to people after the visit to get a new review on the doctor? Maybe you can keep a private list where there is a 1-2, or 3 strike rule based on absolute terrible reviews. When one of these doctors obviously starts to stand out as a bad egg in services provided or toxic environment you just stop listing them. I’m sure the list will be small of blocked providers depending on your criteria that you keep to yourself.

 

[Kevin88660]

If you had a list of doctors that had the cure for cancer, and people were calling you to be connected with those doctors.

But some doctors are terrible, others great, and everything in between.

And you were in position to have a referral program to these doctors, but if the good ones did not join your referral program, then you would not send people to them.

And you could possibly be seen as someone "in it for the money" or unethical because your decision to refer people is based off money.

How would you handle that situation?

The key thing is who pays you.

If the patients are paying you then we can get rid of the conflict of interest issue and then we wont be having this conversation now.

If the patients are not paying you. It is not really a desperate case of cancer patients seeking cancer treatment. Everyone says how desperate they are in need of a service until you ask them to pay.

If the patients want to have you refer doctors to them for free then it is their own job to do their own subsequent Due diligence and not expecting to tap your expertise (telling good from from not so good one) for free.

If the doctors are paying you it is simply a lead generation business model.

The most important business ethic in commercial space and capitalism is to care and work for people who pay you first, before you think about people who don’t pay you.

Because if you cant survive you cannot take care of anyone. It is not going to last if the (greedy) patients expect you to tap your expertise for free while you cannot get anything from the doctors. It makes sense that the less experienced doctors need more aggressive marketing to build their business and base and hence they are more willing to pay you.

Identify who are willing to pay first. They are your customers and take care of them first. Of course no one is asking you to do unethical or promising of over the sky kind of unethical marketing for the doctors.

The golden rule for me is always think for your customers, and the definition of customers are people who pay for your products or service.

 

[Knugs]

If you had a list of doctors that had the cure for cancer, and people were calling you to be connected with those doctors.

But some doctors are terrible, others great, and everything in between.

And you were in position to have a referral program to these doctors, but if the good ones did not join your referral program, then you would not send people to them.

And you could possibly be seen as someone "in it for the money" or unethical because your decision to refer people is based off money.

How would you handle that situation?

As a physician this feels morally wrong towards the patient. I would not want to work with you, if you deny access to medical expertise, because other colleagues chose not to pay you for lead generation. The patient always comes first and your concept is to help these patients find the right expertise.

 

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[Sethamus]

As a physician this feels morally wrong towards the patient. I would not want to work with you, if you deny access to medical expertise, because other colleagues chose not to pay you for lead generation. The patient always comes first and your concept is to help these patients find the right expertise.

With you as physician I can see this point, but the argument is that any physicians that he refers should have the same values of putting their patients first, no matter who he recommends.

I think your viewpoint on morality is too acute. You are not overlooking physicians or denying patients care to top physicians in a referral. Because the bases of the referral is more than who is the best. It is also on availability to receive new patients (which is why they would use your referral) and other factors. As a non professional in the industry do you truly know who is the best of the best or who simply has the best reputation at this point? The two do not always go hand in hand. Someone can be newer in the area that blows the current competition away and has not built up a following yet. That is who is using your services, not the scum bucket doing malpractice.

 

[Knugs]

With you as physician I can see this point, but the argument is that any physicians that he refers should have the same values of putting their patients first, no matter who he recommends.

I think your viewpoint on morality is too acute. You are not overlooking physicians or denying patients care to top physicians in a referral. Because the bases of the referral is more than who is the best. It is also on availability to receive new patients (which is why they would use your referral) and other factors. As a non professional in the industry do you truly know who is the best of the best or who simply has the best reputation at this point? The two do not always go hand in hand. Someone can be newer in the area that blows the current competition away and has not built up a following yet. That is who is using your services, not the scum bucket doing malpractice.

"but if the good ones did not join your referral program, then you would not send people to them."

OP offers a service to help patients find the right expertise but by not including the "good ones", he omits and denys access to "good medical care". He therefore refers Physicians that might not be the "best" or even worse he deceives patients to think they are receiving the "best care". This is how OP has phrased it.

Yes, good medical care has multiple indicators such as reputation, availability, outcomes, empathic communication skills etc. but by excluding top choices based on some of these metrics, because they dont need to pay him, he still denys the patient access and the ability to make an informed choice. Isnt this exactly the value the patient hopes to receive from this service?

A lot of the times availability is a problem with good doctors, because the demand is just too high. The patient should still have the possibility to decide, if they want to wait for that appointment. At the end of the day the patient decides who is the best physician for them. He is literally removing that ability and hence why it fells morally wrong.


btw in Germany I'm legally prohibited to recommend a colleague, because of the conflict of interest that may arise. Something interesting to think about.

 

[sonny_1080]

The key thing is who pays you.

If the patients are paying you then we can get rid of the conflict of interest issue and then we wont be having this conversation now.

If the patients are not paying you. It is not really a desperate case of cancer patients seeking cancer treatment. Everyone says how desperate they are in need of a service until you ask them to pay.

If the patients want to have you refer doctors to them for free then it is their own job to do their own subsequent Due diligence and not expecting to tap your expertise (telling good from from not so good one) for free.

If the doctors are paying you it is simply a lead generation business model.

The most important business ethic in commercial space and capitalism is to care and work for people who pay you first, before you think about people who don’t pay you.

Because if you cant survive you cannot take care of anyone. It is not going to last if the (greedy) patients expect you to tap your expertise for free while you cannot get anything from the doctors. It makes sense that the less experienced doctors need more aggressive marketing to build their business and base and hence they are more willing to pay you.

Identify who are willing to pay first. They are your customers and take care of them first. Of course no one is asking you to do unethical or promising of over the sky kind of unethical marketing for the doctors.

The golden rule for me is always think for your customers, and the definition of customers are people who pay for your products or service.

You're absolutely right and what you say is hugely helpful.

This is going to sound far-fetched because of the doctor/cancer analogy, but it is perfectly applicable to my situation:

What if a doctor literally takes advantage of people, or prescribes them medicine unnecessarily, or just plain doesn't care about the patient - how do you know the doctor you’re referring people to is not doing any of these things?

The way I understand what I think you are saying is: none of this is your responsibility. It is the responsibility of the patient to do his own due-diligence and make his own grown-up decision to use that doctor or not (as long as you're not willingly sending them into a danger zone).

However, in the medical community, people understand the importance of a doctor affiliated with a certain coalition specific to cancer, and if a doctor isn't affiliated with said coalition, then they aren't to be trusted - even if their a fine doctor that a referral would be glad to go to.

That said, if you run a lead generation model and you refer to the doctors (regardless of affiliation) that pay you and leave the due-diligence to the customer - you're getting paid for the referral (value) and you're getting the referral who just wants to see a damn doctor (value) and isn't desperate to find one affiliated with this coalition.

Do you guys see the dilemma here?

I agree that you referring someone to a doctor that is supposed to be good at what he is doing is worthy of its pay. That it is not your responsibility to make sure the doctor is affiliated with this special coalition that other "professionals" deem ethical, especially when the person is choosing to work with that doctor.

But the problem arises when the other "professionals" (possibly your competition) shame the "unethical referral program" because they don't vet the doctors they send people to.

What do you do then?

A) Only work with doctors in this coalition - violates Control commandment giving the coalition control, severely limits provider network thus limiting customer pool and revenue, but keeps people from labeling you as unethical.

B) Create your own vetting process - which can never be fully accurate because you don't know what people don't tell you, adds to the workload making it more time-consuming to onboard new providers, and still might be considered unethical because your vetting process is not as thorough as the coalitions

C) Keep this attitude of whoever pays me gets referrals and the vetting is left to the lead to make their own decision.

 

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[sonny_1080]

As a physician this feels morally wrong towards the patient. I would not want to work with you, if you deny access to medical expertise, because other colleagues chose not to pay you for lead generation. The patient always comes first and your concept is to help these patients find the right expertise.

Exactly my point.

An opposing view.

Thus, my dilemma.

What do you think about what @Kevin88660 and @Speed112 said?

 

[sonny_1080]

With you as physician I can see this point, but the argument is that any physicians that he refers should have the same values of putting their patients first, no matter who he recommends.

I think your viewpoint on morality is too acute. You are not overlooking physicians or denying patients care to top physicians in a referral. Because the bases of the referral is more than who is the best. It is also on availability to receive new patients (which is why they would use your referral) and other factors. As a non professional in the industry do you truly know who is the best of the best or who simply has the best reputation at this point? The two do not always go hand in hand. Someone can be newer in the area that blows the current competition away and has not built up a following yet. That is who is using your services, not the scum bucket doing malpractice.

Keyword here : SHOULD

The fact of the matter is not all of them do. Good, bad, or indifferent, some doctors simply differ in opinion of what is right and what is wrong.

The problem I see you having with what you're saying in this situation is how the public will view you.

His viewpoint on morality is exactly where the dilemma begins because as acute as you may think it is, he is not the only doctor who feels this way.

Ya dig?

But what you say about who truly knows what is best also comes into play, because hey, hypothetically speaking, if there's a coalition that exists to separate the "good" from the "bad" - but the fact of the matter is that there are great doctors not affiliated with this coalition because obviously just because someone isn't affiliated doesn't mean their committing malpractice.

At the same time, your reputation as a referral service is on the line.

You see the dilemma?

So the problem arises when the other "professionals" (possibly your competition) shame the "unethical referral program" because they don't vet the doctors they send people to.

What do you do then?

A) Only work with doctors in this coalition - violates Control commandment giving the coalition control, severely limits provider network thus limiting customer pool and revenue, but keeps people from labeling you as unethical.

B) Create your own vetting process - which can never be fully accurate because you don't know what people don't tell you, adds to the workload making it more time-consuming to onboard new providers, and still might be considered unethical because your vetting process is not as thorough as the coalitions

C) Keep this attitude of whoever pays me gets referrals and the vetting is left to the lead to make their own decision.

 

[sonny_1080]

"but if the good ones did not join your referral program, then you would not send people to them."

OP offers a service to help patients find the right expertise but by not including the "good ones", he omits and denys access to "good medical care". He therefore refers Physicians that might not be the "best" or even worse he deceives patients to think they are receiving the "best care". This is how OP has phrased it.

Yes, good medical care has multiple indicators such as reputation, availability, outcomes, empathic communication skills etc. but by excluding top choices based on some of these metrics, because they dont need to pay him, he still denys the patient access and the ability to make an informed choice. Isnt this exactly the value the patient hopes to receive from this service?

A lot of the times availability is a problem with good doctors, because the demand is just too high. The patient should still have the possibility to decide, if they want to wait for that appointment. At the end of the day the patient decides who is the best physician for them. He is literally removing that ability and hence why it fells morally wrong.


btw in Germany I'm legally prohibited to recommend a colleague, because of the conflict of interest that may arise. Something interesting to think about.

Great points again.

Good and bad are subjective. I should have phrased it this way: if there's a coalition that exists to separate the "good" from the "bad" - but the fact of the matter is that there are great doctors not affiliated with this coalition because obviously just because someone isn't affiliated doesn't mean their committing malpractice.

So therefore, you may be referring patients to doctors that are not held to the same standard as the doctors affiliated with the coalition, but that doesn't mean they are not referable.

Especially when you consider what @Kevin88660 said about its up to them to do their due diligence unless they are willing to pay you to find the best doctor - which let's face it, as much as people complain about shitty doctors, they won't pay for a service like that (generally speaking) when they can just ask around.

You're not denying them access, they can access them just fine somewhere else, just not through you.

This though - "the ability to make an informed choice. Isn't this exactly the value the patient hopes to receive from this service?" is a great point. However, when someone needs a doctor (in our hypothetical scenario), their main concern is price and location - it is definitely more who can get the job done for less over who can do the job the best for more.

All good points though and vital to this conversation so thank you for your input, Doctor.

 

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[Sethamus]

Keyword here : SHOULD

The fact of the matter is not all of them do. Good, bad, or indifferent, some doctors simply differ in opinion of what is right and what is wrong.

The problem I see you having with what you're saying in this situation is how the public will view you.

His viewpoint on morality is exactly where the dilemma begins because as acute as you may think it is, he is not the only doctor who feels this way.

Ya dig?

But what you say about who truly knows what is best also comes into play, because hey, hypothetically speaking, if there's a coalition that exists to separate the "good" from the "bad" - but the fact of the matter is that there are great doctors not affiliated with this coalition because obviously just because someone isn't affiliated doesn't mean their committing malpractice.

At the same time, your reputation as a referral service is on the line.

You see the dilemma?

So the problem arises when the other "professionals" (possibly your competition) shame the "unethical referral program" because they don't vet the doctors they send people to.

What do you do then?

A) Only work with doctors in this coalition - violates Control commandment giving the coalition control, severely limits provider network thus limiting customer pool and revenue, but keeps people from labeling you as unethical.

B) Create your own vetting process - which can never be fully accurate because you don't know what people don't tell you, adds to the workload making it more time-consuming to onboard new providers, and still might be considered unethical because your vetting process is not as thorough as the coalitions

C) Keep this attitude of whoever pays me gets referrals and the vetting is left to the lead to make their own decision.

I would have to do more research into the actual coalition. How do you know this isn’t paid to play as well, which is why some physicians decided not to be apart of it.

Not associated with medicine, but follow me down the rabbit hole.
Did you know the organic food label is a 3rd party vendor approved program? You literally pay for someone( where there are multiple individuals wanting your business) to tell you if it is organic and allow you to use the stamp. There are court battles over this atm as organic is about soil conservation (not fertilizer, or pesticides alone, but the conservation of the soil). Because the marketing and price point is so big compared to nonorganic there are hydroponic farms getting certified organic. Arguably the hydro farms put out a superb product if grown in the right environment as no pesticides are used at all and 90%+ less water is used compared to soil farmers. However, if they do not farm in soil how are they certified organic? Which has led many to market as “beyond organic “ and not pay for the stamp. Yet many have the organic label and I believe it is in the higher courts right now to see if allowed.

 

[sonny_1080]

I would have to do more research into the actual coalition. How do you know this isn’t paid to play as well, which is why some physicians decided not to be apart of it.

Not associated with medicine, but follow me down the rabbit hole.
Did you know the organic food label is a 3rd party vendor approved program? You literally pay for someone( where there are multiple individuals wanting your business) to tell you if it is organic and allow you to use the stamp. There are court battles over this atm as organic is about soil conservation (not fertilizer, or pesticides alone, but the conservation of the soil). Because the marketing and price point is so big compared to nonorganic there are hydroponic farms getting certified organic. Arguably the hydro farms put out a superb product if grown in the right environment as no pesticides are used at all and 90%+ less water is used compared to soil farmers. However, if they do not farm in soil how are they certified organic? Which has led many to market as “beyond organic “ and not pay for the stamp. Yet many have the organic label and I believe it is in the higher courts right now to see if allowed.

It is paid to play, but their value proposition is the vetted certification.

Oh wow. No I did not know that.

Call me slow, and I appreciate what you say here, but I don't follow the relevance.

 

[Sethamus]

I wouldn’t restrict your referrals to only the coalition. Do you think the major supermarkets restrict to only organic? No, because they know that their customers all have different needs.

Maybe you can implement some sort of questionnaire or survey to the people who request physicians. That way you can more closely match them with what they want, vetted coalition or not, and not restrict your market size.

 

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[Kevin88660]

The key thing is who pays you.

If the patients are not paying you. It is not really a desperate case of cancer patients seeking cancer treatment. Everyone says how desperate they are in need of a service until you ask them to pay.

If the patients want to have you refer doctors to them then it is their own job to do their own subsequent Due diligence and not expecting to tap your expertise (telling good from from not so good one) for free.

If the doctors are paying you it is simply a lead generation business model.

The most important business ethic in commercial space and capitalism is to care and work for people who pay you first, before you think about people who don’t pay you.

Because if you cant survive you cannot take care of anyone. It is not going to last if the (greedy) patients expect you to tap your expertise for free while you cannot get anything from the doctors. It makes sense that the less experienced doctors need more aggressive marketing to build their business and base and hence they are more willing to pay you.

Identify who are willing to pay first. They are your customers and take care of them first. Of course no one is asking you to do unethical or promising of over the sky kind of unethical marketing for the doctors.

You're absolutely right and what you say is hugely helpful.

This is going to sound far-fetched because of the doctor/cancer analogy, but it is perfectly applicable to my situation:

What if a doctor literally takes advantage of people, or prescribes them medicine unnecessarily, or just plain doesn't care about the patient - how do you know the doctor you’re referring people to is not doing any of these things?

The way I understand what I think you are saying is: none of this is your responsibility. It is the responsibility of the patient to do his own due-diligence and make his own grown-up decision to use that doctor or not (as long as you're not willingly sending them into a danger zone).

However, in the medical community, people understand the importance of a doctor affiliated with a certain coalition specific to cancer, and if a doctor isn't affiliated with said coalition, then they aren't to be trusted - even if their a fine doctor that a referral would be glad to go to.

That said, if you run a lead generation model and you refer to the doctors (regardless of affiliation) that pay you and leave the due-diligence to the customer - you're getting paid for the referral (value) and you're getting the referral who just wants to see a damn doctor (value) and isn't desperate to find one affiliated with this coalition.

Do you guys see the dilemma here?

I agree that you referring someone to a doctor that is supposed to be good at what he is doing is worthy of its pay. That it is not your responsibility to make sure the doctor is affiliated with this special coalition that other "professionals" deem ethical, especially when the person is choosing to work with that doctor.

But the problem arises when the other "professionals" (possibly your competition) shame the "unethical referral program" because they don't vet the doctors they send people to.

What do you do then?

A) Only work with doctors in this coalition - violates Control commandment giving the coalition control, severely limits provider network thus limiting customer pool and revenue, but keeps people from labeling you as unethical.

B) Create your own vetting process - which can never be fully accurate because you don't know what people don't tell you, adds to the workload making it more time-consuming to onboard new providers, and still might be considered unethical because your vetting process is not as thorough as the coalitions

C) Keep this attitude of whoever pays me gets referrals and the vetting is left to the lead to make their own decision.

Are the patients willing to pay for your vetting process or not?

If they are not willing, which I suspect, then you can only work on the c option.

You cannot sell a service that that customer do not see the value. Many people in this world have to learn the hard way.

I know a good friends of mine who teach programming for a low fee to another common friend. Yet the student choose to sign up for another 5k “guru course” because an expensive course to him should be more legitimate.

We live in an internet world where people assume they know a lot but they don’t. A lot people have to learn the hard way.

Even if you do a good job and took your own time to scrutinize the doctors and offer your hardwork for free, the patients will still come back and blame you as the doctors are “freaking expensive for no reason” and “you probably took their money”. It will break your heart later for underestimating the greed and stupidity of the consumers today. Your good doctors aren’t good for them since they are not doing this and that for free.

You need to remove your bias that consumers are innocent and angel like and producers are out to scam them. Just because some doctors are not doing a good job now doesn’t mean they cannot improve. Business owners generally do want to do good and have clients coming back. They understand how things work, have experience and operate within reasonable boundary. You are 20x more likely to have a bad customer than a bad business person in any industry. Consumers are often tourist to an industry when an issue/problem suddenly pop up.

You can remove the obviously bad doctors who have a super bad reputation, but nothing beyond that in my opinion. I rather be upfront and tell them I get paid by the doctors, the bad agents are removed, and I have a basic vetting process but I can’t guarantee anything else.

 

[Speed112]

You are 20x more likely to have a bad customer than a bad business person in any industry. Consumers are often tourist to an industry when an issue/problem suddenly pop up.

You can remove the obviously bad doctors who have a super bad reputation, but nothing beyond that in my opinion. I rather be upfront and tell them I get paid by the doctors, the bad agents are removed, and I have a basic vetting process but I can’t guarantee anything else.

This is a very important point to make.

I know a business whose entire value proposition is actually... vetting customers!

Their product is still lead gen, for doctors actually, but also Ph.Doctors who are doing research and need people to participate in their clinical trials and studies. It's VERY important to get the right patient through the door, so that they are the best fit for the study at hand.

They're willing to pay quite a bit for that.

And, really, if you've ever worked with people directly, as a coach, consultant, service-provider... you must have met at least a few nightmare clients. People who are more trouble than they're worth. Who give you such incredible headaches you'd almost (if not literally) be willing to pay them to STOP being your client.

In any venture, whether B2B or B2C, qualifying your prospects so they are the right kind of customer is very valuable, because you make sure you're wasting neither your nor their time by barking at the wrong tree.

So maybe, if the plan is to charge doctors for the privilege of sending them leads...

Your service could be curating your list of PATIENTS, not your list of Doctors.

Implement a quiz funnel and pre-screen the patients so that you have an idea about what kind of patient they are, then send them to the right doctor. Not the right doctor for the patient, the right patient for the doctor. Who are you serving? Who's paying you?

So maybe you have a doctor whose niche is breast cancer. You're not gonna send a 55yo dude with prostate cancer to them, would you? If the concern is just a concern, that maybe it might be cancer but they're not sure, there's some weird mole on their shoulder... Are you gonna waste the time of a surgeon who's ready to cut out their tumor? No, you're gonna send them to a dermatologist to diagnose them first. Then, based on the diagnosis, you're gonna refer them to the proper doctor if it's necessary.

This is valuable!!!

(Sidenote: I find it so strange that it's illegal in Germany for doctors to refer people to each other... here it's really difficult to get seen by a specialist if you're NOT referred by a general practitioner or diagnostician. Specialists are busy people. The time they waste seeing people who don't need their skills is time not spent treating people who do. By optimizing the supply and demand of healthcare, you're increasing the output of healthcare workers... thus saving lives! Or years of life at least.)

You're saving the time of both the doctors and the patients and helping supply and demand meet more efficiently. And there's nothing unethical about discriminating in this process, because discriminating is the whole point of the process!

That is, if you're discriminating based on how well people's needs fit with each other, and not irrelevant things like hair color or race. Although these CAN be relevant, and if they are, there's nothing wrong with them.

If you've got a doctor in a predominantly Asian area, who is specialized in serving Asian people and their particular needs, and one of your patients specifically stresses that they prefer to go to an Asian doctor, what would be better? Pairing the two, or sending them to some Latino doctor who only speaks Spanish in spite of everyone's preferences?

I think the only moral question that is relevant for this whole thing is whether or not you're helping people and providing a valuable service. And the way you figure that out is... by being profitable! You can't keep the lights on and continue helping people if you're losing money while doing it.

As long as people are willing to use your service and pay you for it, you must be doing something right. If people appreciate your service and refer you to others, you must be doing something really right. It doesn't matter if at the same time there are parties interested in shutting you down. There will always be haters. Because if you're HONESTLY helping people get what THEY want, regardless of what society or some "coalition" think they ought to want, then you're doing good.

There is no such thing as an absolute moral authority in this world. We're not living in a global theocracy and nobody can say what's right for everyone. Not the pope, not Biden, not Trump, not Xi Jinping, not Fauci or Bill Gates or Elon Musk, not the leader of your local HOA, or the director of the Coalition of Ethical Doctors of Earth Who Are Totally Not A Cartel, or your grandma, or me, or MJ, or anyone else on this forum.

So asking us "what's moral" and what you should believe the right way to go is pointless. Because even if everyone on the forum is of the same mind and gives you the right answer, which will only happen if we all happen to be philosophically-educated and have thought about this particular matter AND we happen to have the same values and underlying principles...

We're still only a small subset of the world population.

A communist might view it as immoral for you to charge for anything. They might view it immoral for the doctors themselves to charge for the service they provide to the patient. So how could you, a filthy intermediary who does nothing useful but just leeches off the need of the people, dare to even consider charging others for the privilege of access to a HUMAN RIGHT, when the doctors ought not to either? How dare you restrict that access to the people?! And how could you charge a fee for facilitating a service that's free (and provided by literal slaves)? You can't. It's immoral. Give up and subject yourself to the collective.

Does that sound reasonable to you?

Different people have different values. Some want some things while others want other things. Your job as an entrepreneur is to accept that reality and manage risk while doing your best to meet the wants of different people in the middle to provide them a valuable service.

Whether or not unreasonable people will attempt to harm you in your righteous attempt of doing good is, sadly, part of the risks you've got to manage.

So, in conclusion... deal with it.

 

[sonny_1080]

You need to remove your bias that consumers are innocent and angel like and producers are out to scam them.

I think this limiting belief is exactly what the problem is.

 

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[sonny_1080]

@Kevin88660 and @Speed112

Thank you

I need more people like you in my life.

In all seriousness, what do I have to do to be your friend

 

[Kak]

I poured into this a bit!

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