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January 23, 1932


Author Affiliations

Los Angeles

JAMA. 1932;98(4):339. doi:10.1001/jama.1932.02730300069032

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To the Editor:  —The weakness of most editorials on the subject of fee splitting seems to lie in incomplete analyses of the reasons underlying the practice and the lack of corrective suggestions.The editorial on fee splitting (The Journal, Dec. 5, 1931, p. 1710) covers the "old ethical problem" in the same old ethical way. It assigns the reason for fee splitting largely to economic necessity and in so many words implies both that dishonesty pays and that a doctor can make more money by fee splitting than by assiduously building a legitimate and ethical practice.My personal opinion is that the cause of rebating and fee splitting, in probably 75 per cent of all cases, is personal inefficiency on the part of the doctor. Where such inefficiency is found there generally exists a concomitant dishonesty.When a doctor stoops to fee splitting he brands himself an inferior. He cannot

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