The Richmond palladium and sun-telegram. [volume] (Richmond, Ind.) 1907-1939, 1913-09-30
HOW FEE SPLITTING
IS DONE TO STEAL
THE VICTIMS COIN
CONTINUED from Page ID

Objectionable. Where surgeon sub
mits a bill to cover entire cost of case
and allows the practitioner share
with the consent Of the patient, of
course no harm is done. But real fee
splitting is a secret bargain entered
into by surgeon and practitioner
whereby unknown to the patient the
practitioner receives a percentage of
the fee, not for any work done, but
simply for referring the patient"
Fee splitting is attended by many
evils. One surgeon will obtain a mo-
nopoly of the work by offering high
er percentage than another surgeon
can afford. He may be less competent
than his competitors, but secures the
bulk of the practice because he buys
1t from the practitioners. Oltantimes
he will charge exorbitant rates in or
der to have fee big enough to split.
BY monopoliZing the business he
Yields tremendous influence over
physicians in his community. When
patient finds he needs an operation he
will naturally demand that the best
known surgeon do the work. This
ties up honest practitioners to dis
honest surgeon.
Working the Game.
Where fee splitting becomes the
rule, the practitioners guilty will find
many ways of holding up an honest
surgeon. The practitioner sometimes
will make charge to cover the entire
expense of operation and treatment,
telling the patient that the surgeon is
to receive 5000 But when he comes
to settle with the surgeon, he pays
him only 500 and keeps the balance.
The surgeon believes the patient has
paid him only $780, the patient be-
liayes he has paid the surgeon 5000.
The practitioner has stolen 500.
Oftentimes fee splitting will cause
operations that are unnecessary.
Where practitioner refers a case
for operation the surgeon is compelled
to operate even il he knows it is not
operable Because he cannot afford to
dissatisfy man who sends him so
much business.
If surgeon is giving one half his
kfees to practitioners, he becomes hard
Epreesed i'm order to make the usual
Surgeons income. Because of that he
Twill be tempted to operate cases not
needing 1t in order to get the fee for
himself
Fee Splitting Grows.
Al surgeon not dividing fees will
Sometimes be forced to divide because
khf his pressing need. He is receiving
] korsNttle trade because of a compel
/ Ing surgeon who has monopolized the
business, he yields at last to tempta-
tion to divide because of his financial
needs. Fee splitting will thus grow
by what it feeds upon.
This tends in the long run to raise
the price of surgery. To have a suffi-
cient payment for work done after
he practitioner has received his
Bhare, surgeons gradually will raise
their prices. Where a surgeon has
made q reputation because of the
|amount of work fee splitting has
#brought him, he becomes able to ex-
tort high fees. He uses reputation
|dishonestly gained as a club to use on
patients.
Where a practitioner receives a di-
vision his money is obtained by false
representations.
Fee splitting is the result Of a grad
nal evolution from a practice once in
nocent. In the period when specialists
were first differentiated from regular
practitioners, the attending physician
was often engaged as assistant In
that case the fee sometimes was di-
vided.. As a result of the further df
vision of function among doctors, this
n0wsh has become an evil.
Local physicians are demanding
drastic action. They believe the prac-
tice should be given adequate publ
city. In this way they hope laymen
will be on the lookout and demand
that the practitioner submit a separ-
ate and timezide bill. II it cannot be
checked any other way, they will not
hesitate to advocate state law, max
ing the practice misdemeanor