The Detroit times. [volume] (Detroit, Mich.) 1903-1920, 1910-02-21
MORE PHYSICIANS
SCORE PRACTICE
Splitting of Fees Between Specials.
and General Practitioner Is Gen.
orally Denounced.

ehSe GU place Ilnplclt cOnndelCe
IN your physician u advise you as -
the most competent surgeon. lie
tells you that DR. A is a most skill
ful man, but his charges are high.
However he advises thai the patient
be submitted 20 DR.. A for operation.
Your doctor knows your circum-
stances, and the fee is fixed in pro
portion. and you And that your ply
stefan has taken advantage OF the con
iidence YOU have placed In him to
obtain sum OF money from you
which he hadn't the courage TO ask OF
you himself, how would you view such
conduct"
Thus Or. Theo. A. McGraw, Sr,
places himself in the position OF the
interested layman In his contribution
10 the Detroit Medical Journals sym
postum on the question OF the division
Of fees, ASKING question that has oc-
CURED TO many a lay mind since The
Times took up the matter The Times
story OF last Friday has aroused
great interest in the subject both in
and out OF the medical profession.
and has Given rise TO an earnest and
widespread discussion OF the prln
ciples involved.
81 think the principle OF division OF
fees is disastrous to the morale Ut
the profession. said DR. McGraw.
When surgeon has 10 offer financial
inducements in the shape OF comm;s.
sions TO doctors in order TO create
business, the patient, Of necessity,
suffers. The tendency is 10 cause un
scrupulous practitioners To hunt UP
as many patients a possible for ope-
ration. and In maLy cases the opera
ton is wholly unnecessary. II means
That the surgeon offering the induce
. ment would not have secured the pa.
3 tent otherwise. Ii the general prac
4 titioner thinks his services to the pa.
4 tient are worth more than he gets.
T let him charge a higher fee and not
7 try TO get 1t by merging his Dill into
i that OF the surgeon
2 Il am afraid this evil has come 20
stay. II our county or state medical
5 societies would undertake 10 deal with
I the matter and would fix the sum or
y percentage of the surgeons fee that
should 60 TO the general practitioner
! referring the case, and proclaim II 10
the public so that the laity would
y know that such practice existed, IL
l. would tend to deprive it OF the ele-
: ment OF dishonesty Such an action
on the part OF our medical societies
would do much towards mitigating
g the evil. hut it would not prevent the
surgeon from degrading the profeS
. sion by offering pecuniary induce
ments."
Dr. w. j. Stapleton. Jr, former
county physician. Is another of those
who believe that the whote matter re-
g wolves around the patient.
Ordinarily. IL patient is sent to
J. specialist without the family ply
i stefan having anything TO do with the
e case. | think the matter should end
d there" he says, in the Medical Jour
z nal. mo fee should pass. On the
4 other hand where e patient Is sent
J. to a consutant and an operation per
. formed, where the general practitioner
: assists and has the aftercare of the
patient. ne should be paid fee for
, assisting at the operation. The split
l. ting of fees leaves loophole where
5 unscrupulous men are concerned. IL
4 means that the patient gets the worst
t OF the deal his case going 10 the man
J. who gives the largest commission,
: egardless OF his fitness to do the
d work. DO unto others as YOU would
be done by.
= What stand do | take regarding
= the division OF fees?" would nos
s entertain the proposition gnder any
consideration. said DR.. David lnglis.
Let me give you an instance or the
only time / was ever asked to divide
my fee A young man, whom | helped
10 educate and assisted In other ways
came TO me one dav' and said he had
r patient ne wished TO refer TO me
y The patient was wealthy, he said, ana
4 advised me to fix my fee in keeping
5 with the mans financial standing.
t Then he put the question TO me. How
K much are you willing To give me oui
of the fee? Not u cent | told him
did not do business that way. IL
. ne wanted some consideration, lie
J. must have the understanding with
: tho patient himself That was the
= last and only time | was ever asked
i tc divide my fees with "A physician
= Who referred a patient TO me. oh
: ject to the principle; il isn't honest
: Why should | De a party TO any 81
cret arrangement Ct which the pa
u tjent who pays the fee is not cog
rizant?"
E Dr. Max Baliin stated his views
: clearly and forceluIly lie salo
: My principle az - fee-splitting Is
this The consulting physician ought
= 10 be paid for his trouble and respon
. sibilitv ia bringing a patient tu 4
> certain specialist BGt thu family ply
!. stefan should have enough la k-bonJ
= Ia present his claim before the pa
tent. and not require from the sp"
= c.alist a 'divy up Oh the sly. The
consulted specialist should see tu !,
az far as possiDl, that such claim
are mstl, met The specialist was
drums ND patient. by promising -
}. ID ami - per colt ~ a menace ii
specialists family physicians and pa
. iieuts. The rule I'm all these questions
: il laid .down clearly by he Ameri an
Medical ass0ciUtion: she patient oughl
!, a. know how much pf his money goes
> 10 each one inutCrCsieG in his case
- Or J. " Harrison believes that Tao
y division Ut fees H.. proper and IeEld
- mate under certain conditions.
- II do not thin0 a doctor VINO makes
a suetiaity ut surgery or any ntNef
department OF medicine. should IT.
r yide his zee witl the physician semi
!. inr him paient. nof should he
o asked 10 no so. ii he confines himseli
..gtY- 90 his sDe-ialty" said hC.