The Sunday telegram. [volume] (Clarksburg, W. Va.) 1914-1927, 1915-10-31


often noted that q certain physician
keeps a stream Of patients flowing to
a certain operator. This may not be
the result Of fee splitting, but it
should cause one to investigate furth-
er in case he is anticipating the need
Of operation. There are clinics to
which physicians go in large NUM-
bers. Occasionally It happens that
some physician will be visiting one
Of these clinics at. time when some
patient Of his is there. What has been
written above may incline that patient
to suspect that fee splitting is taking
place. In that event, ! think the fol-
lowing rule can be applied. There is
no great clinic in this country that is
run on fee splitting basis. The rep
utations of these clinics keep them
full Of patients. They do not nc
to pay commissions, and they do not.
The difficulty in deciding why the
physician came along will be more
difficult when the operator is less we'll
known, and the clinic is less Of a
mecca for physicians In most Of
such cases, II the patient will spend
a little time in investigating, he will
be able to find out the reputation Of
the operator on the fee splitting ques-
ton. In most instances he will find
that the operator in question gets the
business on the basis Of his skill. In
some instances he will find that his
home physician and the operator pro-
posed have regulations for being fee
splitters. All in all, reasonably fn-
telligent man, exercising a fair de-
gree Of caution, should be able to
.diagnoe the fee splitters.
Fee splitting among medical men
is an evil from which both patients
and physicians suffer the conse-
iquences. Those who practice it con-
stitute minority Of the profession
in bad odor among their associates.
Patients can know them by certain
signs.
Is there any remedy for the prac-
tice? Especially, is there any means
by which people may end the prac-
tice of fee splitting among physic-
fans? incidentally. by which man
may safeguard himself against fee
'splitters?
The reason, at least one Of the reas-
ons, why fee splitting is legal and
moral among lawyers and business
men, and illegal and immoral among
doctors. is because among the former
fee splitting. called brokerage fees, or
lby other names, is an above board
transaction. 1t is advertised widely.
The fees, when not paid, are sued for
and recovered in the courts. 1t Is
thoroughly established in custom. The
man who pays knows before he starts
who gets the money, and how much
he is to get. II the fee splitting phys
icians would be equally open in their
transactions, the state laws against
fee splitting would fail to cover the
case, and in time the custom of fee
splitting might be established. But
that will not be the solution Of fee
splitting, because the men who prac-
ltice it could not profit by any fair
procedure. They live by taking UNI
fair advantage Of their patients. and
of physicians generally. They would
oppose this proposal, because 1t would
be in the interest Of fairness. AS
they are the people who benefit from
the coil OF fee splitting, their OPPOSE
ton would kill the proposal.
| Is there any other remedy? The
various state laws are partial rem
edies. They do not, will not, and can
not cure, but they help. The action
of the American Medical Association,
American College of Surgeons and the
various state and local health socie-
ties are partial remedies. They can
not cure, but help.
The complete remedy, as see 1t
lilies with the people themselves
Twenty years ago there were but few
hospitals, and the people knew moth
ing about operators. There was deer
mystery about surgeons, operators
generally, surgery, and all things
surgical. In consequence Of this, ig-
norance and mystery, abuse of var
ious kinds was inevitable.
Says Saleeby, in Surgery and So
ciety, Dishonest men there will be
amongst the ranks Of surgeons as
amongst the ranks Of bishops, and
the enemies Of surgery, or Of episco-
pacy, will make the most of the fact"
1t is to the credit Of the profession
that the proportion Of fee splttters
among surgeons ID less lnau teA pel
cent, and among physicians at large is
still smaller.
But at present there is no occasion
for mystery and no justification for
Ignorance. Every man should be well
enough informed to decide for hinl-
self who is to operate. and how much
he is to pay. and to whom. Among
people generally there is an erron-
eous idea as to who decides for a
man, what doctor shall care for him,
what treatment shall be given, what
diagnosis shall form the basis OF
treatment. The erroneous opinion is
that the physician decides. The law
holds that the patient himself decides
each Of these questions. The doctor
makes his examination, states what
he has found. what he thinks, and
what he advises. The patient, having
heard the physician's statement,
makes his decision.
Is 1t possible for a patient to pick
out his operator without making an
excessive number of mistakes? Yes.
How? There are medical directories
in, considerable number. One Of these.
the American Medical Directory.
gives the age. the school Of gradua-
iNlny. IN ,4ot.ft &fant arnat.fn1Ne and as.