Physicians gaming the system: modern-day Robin Hood?

character Robin Hood as a hero who stole from the rich to give to the poor. Even if we were all taught that stealing was something bad, in certain circumstances, we would consider it acceptable if the goal were laudable. Perhaps our hero is simply a petty thief. But what if the gold that Robin Hood stole had an impact on an entire village? What if the stolen gold was intended for all of the villagers in order to pay them for their yearly harvests, but because of the justifiable robbery , none of them could therefore be paid? Would we have as much sympathy for Robin Hood or accept his act of thiev-ery? To a certain extent, the actions of doctors can lead us to consider them as the " Modern-Day Robin Hood ". Indeed, in order to help their patients, some physicians choose to break health care rules and regulations regarding access to care and/or reimbursement 1 , that is, gaming the system for the personal benefit of individuals in need. Compared to fraud, gaming is essentially based on altruistic motives and is not primarily carried out from a perspective of self-interest. Those who use gaming will resort to such tactics as over-claiming (e.g. billing for an insured service while providing an uninsured service) or will misrepresent patient data (e.g. queue-jumping, misclassification — for example, exaggerating the severity of an individual patient's condition to obtain more expeditious care or to help a patient secure coverage for required care). 2 People's opinions, with respect to gaming, vary greatly. Some believe that the practice of gaming indirectly promotes equity and quality in the allocation of health care resources by allowing doctors to offer required health care services to patients who otherwise would not receive such care. Furthermore, some physicians believe it is their role to determine priorities among their patients, even if they must bypass the system in order to do so. To others, gaming renders the health care system susceptible to important repercussions, such as increased overall costs and a reduction of the quality of health care services. 3 Should something be done about gaming? If so, what exactly? In this article, I will argue that, even if it sometimes appears to be praiseworthy, gaming is not a good practice in general, and its potential impact on the health care system is sufficiently significant to substantiate intervention. Thereafter , …