The Detroit times., 1910-02-23
LACKS CONFIDENCE
IN FEE-D|v|DERS
Physician Never Sends Members of
Own, Family To Surgeon Who
~, Splits" Says DR.. Hirschman.,

~ 10 Al lat AldA l'S-
diyider seeking an operation for him
self or member OF mis- family. Will,
as a general rule, employ someone
other than the specialist 10 whom he
has ben in the habit OF sending his
cases.
This was the statement OF Or. Louis
j. Hirschman. 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 or
dividing fees continued the doctor,
For the sake of pecuinary gain, the
INSCRIPTIONS general practitioner VIII
send his patients 10 the specialist who
will give him the biggest divyy.
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 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 fundamentals
! Is wrong The average physician IS
not as we'll paid as skilled mechanic.
They may be doing $500 10 $500
worth OF business ever month. but
/ they are not collecting more than hall
that amount.
"A physician should charge for the
service performed just as surgeon
! charges for an operation. Take, Tor
/ instance. case of typhoid fever. The
| physician calls twice day we VIII
say. for six weeks. at 81 per visit. he
receives for his services on thar basis
ISlGS For performing an operation
! for APPENDICITIS and attending the
patient during convalesence IL is not
uncommon for q surgeon TO charg"
$3.50 Just notice the disparity, YET
IL requires just az much skill TO sue
cpssfully 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 a correct diagnosis
and is present at an operation to give
! the surgeon the benefit OF his knowl'
! edge of the patients general condi-
ton is entitled TO pay for his SER
I -
surgeon should be made the coliec-
ton agency. IL Is proper lot TUG
surgeon "a explain to the patient or
his relatives why the physician is en-
titled to pensation, but that Is as
far as he should go.
"One great reason why physicians
are so poorly paid for these services
is that some surgeons charge ont OF
ali proportion to the patients ability
TO pay for an operation. knew or
case where a man earning $40 Week..
with four children to support, was
charged 5000 for an operation on his
wife. and he was obliged to sacrifice
his home to settle the bill. There are
many cases just like that. and natur-
ally there is but little left to square
matters with the physician who
recommended the operation.
Another very vicious feature OF
this feesplitting evil is that some
surgeons follow this plan until the
Get established and then Quit. II is n
bad example for young men just en-
tering the profession. Surgeons, II
some instances. ask physicians To
come In and assist them in an opera
ton merely as a subterfuge TO pay
ther p commission The AVERAGE
phvsician makes Il poor assistant In
surgical operation. and this practice
very often places the patient in grave
danger. The physicians business nm
der such circumstances is 10 advi@"
as 10 the patients general condition
and not TO assist I'm the operation