The Detroit times. [volume] (Detroit, Mich.) 1903-1920, 1910-02-22
LACK CONFIDENCE
IN FEE-O|V|OERS
Physician Never Sends Members of
Own Family To Surgeon Who
Splits" Says DR.. Hirschman.

1T is a significant fact that a fee
divider' seeking an operation for him
self or a member OF his family, will,
as general rule. employ someone
other than the specialist TO whom he
has been in the hibit of sending his
cases"
This was the statement of DR.. Louis
j. Hirschman. a physician and surgeon
Of high standing in the profession, to
The Times. The statement requires
no explanation. The fact speaks for
itself.
1T shows the real evil that turks
behind the pernicious practice OF
dividing fees" continued the doctor.
For the sake OF pecuinary gain, the
interruptions general practitioner will
send his patients TO the specialist who
will give him the biggest 'divvy.'
When his own life or the life of one
near and dear TO him Is at stake, IL
is a different proposition. Then he
selects a surgeon he knows 10 be
competent
"One great reason why this fee
splitting evil exists is that the pres
ent system OF charging on the basis
OF so much per visit is fundamental
IL wrong. The average physician Is
not as well paid as a skilled mechanic.
They may be doing $500 TO $500
worth OF business every month, but
they are not collecting more than half
that amount.
"A physician should charge for the
service performed just as a surgeon
charges for an operation. Take, for
instance. a case of typhoid fever. the
physician calls twice a day, we viii
saw. for six weeks. at 50 per visit. He
receives for his services on that basis
s168 For performing an operation
for appendicitis and attending the
patient during convalesence 1t Is not
uncommon for a surgeon TO charge
$3.50 Just notice the disparity, yet
IL REQUIRES Just as much skill TO sue
cessfullv treat a case OF typhoid fever
as il does to perform an operation Tor
appendicitis. and the physician gives
vastly more of his time and attention
to the patient.
There is no question that ply
stefan who makes correct dlaghosls
and is present at an operation 10 give
tho surgeon the benefit OF his knowl-
edge of the patients general condi-
tion is entitled TO pay for MS ser
vices. but there is no reason why the
surgeon should be made the collec'
ton agency. 1t Is proper Tor tho
surgeon q explain to the patient or
his relatives why the physician Is en-
titled 10 compensation, but that is as
far as he should 20.
"One great reason why PHYSICIANS
are so poorly paid for these services
is that some surgeons charge OUT OF
all proportion 20 the patients aoillty
10 nav for all operation. | knew or
case where a man earning $40 week.
with four children TO support was
charged 5000 for an operation on MIS-
wife and he was obliged to sacrihce
hi. home to settle the bill. There are
many cases lust like that, and natur-
civ there is but little left TO square
matters with the physician VINO
recommended the operation.
"Another very vicious feature OF
THE fee-splitting evil is that some
surgeons follow this plan until they
cot established and then quit. IL Is
bad example for young men just en-
terinq the profession. Surgeons In
some instances. ask physicians TO
come IN and assist them in an opera
ION merely as a subterfuge 10 pay
-, oom,,ission The average
nhrs,cia, makes poor assistant In
surgical operation. and THIS pracllCe
very often places the patient III grave
danger. The PHYSICIANS business IN
der, such circumstances Is To advise
az 10 the patients general CONDITION
and not TO assist in the operation