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December 5, 1931


JAMA. 1931;97(23):1710. doi:10.1001/jama.1931.02730230052014

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A basic principle in medical practice demands that the physician call as a consultant the best available man for the purpose. That principle is determined, of course, by a fundamental consideration: the one impelling motive in every action taken by a physician must be the good of his patient. For these primary reasons, ethical physicians oppose fee splitting in any way, shape, manner or form. Every one now realizes that the general practitioner who makes the diagnosis and who is primarily responsible for the care of the patient deserves a much greater percentage of what the patient is able to pay than he actually gets when the patient is referred to a surgical, otolaryngologic, ophthalmologic or other consultant. Nevertheless, if this is accomplished by the secret division of fees it is an abomination full of evils. If patients could come to understand that the general practitioner's fee, when a specialistic

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