The Topeka state journal. [volume] (Topeka, Kansas) 1892-1980, 1914-07-29
FEE-sPLI1TING.

- 1nQul8ed In by physicians ana sur
geons. And the expressions Of regret
are general that the Kansas State Med
ical Association did not take advantage
Of its opportunity at its last meeting
to endorse the resolution. presented Tor
.ts consideration, condemning this m
defensible custom that has developed
among the members of the medical fra
ternity. Among the many newspapers
giving attention and editorial consider
alton to this matter are the Kansas
City Journal and the Wichita Beacon.
And the former had this to say:
':The Kansas State Medical Associa-
ton. in refusing to condemn fee-split-
ting. has formally Endorsed a medical
fraud very common in that and other
states.
"The fraud Is this: The surgeon
charges a double fee for performing an
operation. and secretly divides the fee
with the family physician. 1t is well
known In inner circles that secret fee
splitting IL almost universal in Kansas.
and the state association. by refusing
to condemn the practice. in effect adj
mits and justifies 1t. The surgeon gives
the family doctor. who brings in the
business. so per cent of the fee. Some
times the per cent is Is. If the patient.
or the family of the patient. were in
formed of the fact in advance OF the
operation, or even after it. there would
be no fraud about it: but the secret
splitting of fees is grossly immoral.
The patient clearly is deceived. Or
dinarily he reasons to himself: MY
dear family doctor certainly would not
recommend this operation unless he
was sure it was necessary: there Is
nothing in it for him. He would GER
tainly have it done at the lowest pos
sible cost; there is nothing in 1t for
him. 1t is a fragrant fraud practiced
on patients and families at time
when, often in the shadow Of death.
they are in no frame of mind to de-
fend themselves.
mot only this. but the practice Is
a constant temptation to the family
doctor to recommend operations when
operations are unnecessary. He says
to himself when he yields to the
Here Is Smith; he can
pay, within a year or two. 1000; half
of that will come to me. He thinks
there is something the matter with his
appendix; maybe there is. I guess I'll
an operation; that will pay
half the mortgage on my little home.
I have to work awfully hard anyhow
That $500. or part of it. at least. is vel
vet: It is graft.
1.-THE family doctor is entitled to
more than s. visit in case
of an operation; a skillful diagnosis is
worth money; the responsibility as
sumed calls for compensation. But the
doctor should make his bill and
the surgeon his. Secret fee-splitting is
fraud.
Here is opportunity for real reform
by legislation. In England, we under
stand, surgeons fees-the fees collect
able by law-are regulated. Those who
are able to pay more pay as they like.
through gratitude The doctx3rs are be-
fore the legislatures asking protection
against quacks nearly all the time. If
they are given sort of monopoly. they
should be regulated.
Another way of reaching the evil
would be to require all surgeons to
make an annual report. under oath.
giving the name Of patients operated
on, the amount Of the fee charged. and
the division, II any. made thereof.
"Fee-splittinR appears to be almost
universal in Kansas. The Kansas leg
islature might well begin the reform.
The practice. however. is not confined
to Kansas. It prevails in other states
also, and is not unknown in Missouri"
The Wichita Beacon had this to say
on the subject:
1.-The Kansas Medical Society in its
meeting at Wichita made a splendid
start when 1t declared its intention to
fight quackery in all it's forms and to
fight in the open, but it stopped too
soon in its reformatory spirit when it
laid upon the table a resolution de-
manding that Kansas pass a law pro-
hibiting the secret division Of fees be-
tween surgeons and doctors.
There's only one way to settle the
fight against fee-splitting. and that's
to settle it right. While It remains as
an open practice Ii. any considerable
percentage Of the reputable doctors
and surgeons Of Kansas. the profession
in this state suffers a black eye. The
doctors have little right to complain
about the ethics of newspapers that
take rotten advertising or the ethics of
the quacks themselves. so long as they
continue to indorse by their silence as
a society the inhurnan and .arbarous
practice Of fee splitting.
The Beacon does not say this as a
justification for newspapers which con-
tinue to run rotten medical advertise
ments. Lack Of ideals in the medical
profession does not justify lack pl
ideals in the newspaper profession. II
the newspapers and the doctors would
work together for the creation of clean
medical advertising and clean nantes
tations Of the medical profession which
in its power to serve is the noblest in
the world.