Fee splitting


Fee splitting

Fee splitting is the practice of sharing fees with professional colleagues, such as physicians or lawyers, in return for being sent referrals [http://www.answers.com/topic/fee-splitting] .

Fee splitting in medician and healthcare

This is essentially the payment of a commission to the referrer with the express intention of ensuring that the referring doctor directs referrals of patients to the payee.

In most parts of the world, the practice is considered unethical and unnacceptable, hence fee splitting is often covert. The reason it is believed not to be in the interests of patients is because it represents a conflict of interest which may adversely affect patient care and well-being, since patients will not necessarily be referred to the most appropriate doctor to provide their on-going care but will instead be referred to those doctors or hospitals with whom the referring doctor has a "fee splitting" or commission payment type of arrangement.

Fee splitting in the USA

The situation in the USA is not entirely clear. [http://www.time.com/time/magazine/article/0,9171,771534-2,00.html]

According to the World Medical Association [http://www.wma.net/e/meetings/leaders1.htm] , "The AMA Code provides that payment by or to a physician solely for the referral of a patient is unethical as is the acceptance by a physician of payment of any kind, and in any form, from any source such as a pharmaceutical company or pharmacist or a manufacturer of medical appliances and devices, for referring a patient to that source. Another section specifies that clinics, laboratories, hospitals or other health care facilities which compensate physicians for referral of patients are engaged in fee-splitting, which is unethical".

Among its "Definitions of Unprofessional Conduct", the "West Hudson Psychiatric Society Virtual Newsletter" (1997) lists "2Offering, giving or receiving a fee for the referral of a patient (fee splitting), or permitting any person other than an employee or associate to share in your fee, who has not provided an appropriate service directly under your supervision2". [http://www.rfmh.org/whps/syn1197.html]

However, the practice, or something resembling it, tends to be tolerated - in "Medicine, Money, and Morals: Physicians' Conflicts of Interest" by Marc A. Rodwin, forms of fee splitting and commission paying for referrals remain common in the USA and are in effect tolerated by key overseeing bodies such as the American Medical Association and Joint Commission International, or JCI. [http://books.google.co.uk/books?id=nsUKs1ovVmYC&pg=PA41&lpg=PA41&dq=joint+commission+fee+splitting&source=web&ots=_CyAWz_4xn&sig=ZUZNhoBXpAUjybvjXYn5ZZ-wchI&hl=en]

According to their website, the Joint Commission (JCI) have no published view on the issue of fee splitting, and in fact the Joint Commission stopped trying to provide guidance on medical ethics to American hospitals many years ago [http://books.google.co.uk/books?id=nsUKs1ovVmYC&pg=PA41&lpg=PA41&dq=joint+commission+fee+splitting&source=web&ots=_CyAWz_4xn&sig=ZUZNhoBXpAUjybvjXYn5ZZ-wchI&hl=en] , preferring to concentrate on less challenging areas of healthcare assessment, despite the vast importance of medical ethics to patient safety. It is not clear if JCI operate to a similar level of standards when working outside of the USA.

Fee splitting continues within the USA, and according to Time magazine has "grown to alarming proportions". [http://www.time.com/time/magazine/article/0,9171,737214,00.html]

Fee splitting in the United Kingdom

Fee splitting and similar practices are considered unequivocally unacceptable for the medical profession in the United Kingdom.

The practice is considered unethical, and offenders can be disciplined and even "struck off the medical register". [http://www.gmc-uk.org/guidance/archive/func_proced_and_dis_jan_1970.pdf] This is not to say that it does not happen.

Fee splitting in other countries

Fee splitting in the medical profession of various sorts has been alleged in Malta, [http://www.maltatoday.com.mt/midweek/2007/11/14/n2.html] Malaysia, [http://www.prlog.org/10039052-doctors-against-ing-proposal-that-will-disrupt-patient-care.html] Singapore, [http://news.sma.org.sg/3903/Forum.pdf] Thailand, [http://www.bumrungraddeath.com/pages/news_details.cfm?id=112] and India. [http://www.bmj.com/cgi/eletters/326/7379/10/c]

ee also

* Medical ethics
* Medical Protection Society
* Medical tourism
* Hospital accreditation
* International healthcare accreditation
* Hospital accreditation
* Patient safety

External links

* [http://www.wma.net/e/meetings/leaders1.htm]
* [http://www.gmc-uk.org/guidance/archive/func_proced_and_dis_jan_1970.pdf]
* [http://www.aaem.org/feesplitting/602.php]
* [http://www.time.com/time/magazine/article/0,9171,737214,00.html]
* [http://www.rfmh.org/whps/syn1197.html]
* [http://books.google.co.uk/books?id=nsUKs1ovVmYC&pg=PA41&lpg=PA41&dq=joint+commission+fee+splitting&source=web&ots=_CyAWz_4xn&sig=ZUZNhoBXpAUjybvjXYn5ZZ-wchI&hl=en]
* [http://www.sma.org.sg/sma_news/3710/advisory.pdf]


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Look at other dictionaries:

  • fee-splitting — ☆ fee splitting [fē′split΄iŋ ] n. the practice of giving part of the fee charged a referred client or patient to a colleague who makes the referral: it is considered an unethical practice in the medical profession …   English World dictionary

  • fee-splitting — fee splitter, n. /fee split ing/, n. the practice of dividing a fee for professional services between two professional persons, as between a referring doctor and a specialist, without the knowledge of the client. [1940 45] * * * …   Universalium

  • fee splitting — fee split·ting fē .split iŋ n payment by a medical specialist (as a surgeon) of a part of the specialist s fee to the physician who made the referral fee split·ter ər n …   Medical dictionary

  • fee-splitting — fee′ split ting n. the practice of dividing a fee for professional services between two professional persons, as between a referring doctor and a specialist • Etymology: 1940–45 fee′ split ter, n …   From formal English to slang

  • fee-splitting — fee splitter, n. /fee split ing/, n. the practice of dividing a fee for professional services between two professional persons, as between a referring doctor and a specialist, without the knowledge of the client. [1940 45] …   Useful english dictionary

  • fee-splitting — fee split·ting (feґsplit″ing) the division of moneys received by a specialist, such as a surgeon, between the specialist and the physician who referred the patient …   Medical dictionary

  • fee splitting — noun payment (usually by doctors or lawyers) of part of the fee in return for the referral • Hypernyms: ↑payment, ↑defrayal, ↑defrayment * * * noun : a dividing of a professional fee for specialist s medical services with the recommending… …   Useful english dictionary

  • fee splitting — noun Date: 1943 payment by a specialist (as a doctor or a lawyer) of a part of his or her fee to the person who made the referral …   New Collegiate Dictionary

  • fee splitting — Division of legal fees between attorney who handles matters and attorney who referred such to him or her. Referrals commonly occur when referring attorney lacks expertise, or experience to effectively handle the particular matter …   Black's law dictionary

  • fee splitting — Division of legal fees between attorney who handles matters and attorney who referred such to him or her. Referrals commonly occur when referring attorney lacks expertise, or experience to effectively handle the particular matter …   Black's law dictionary