Edited by Jennifer Reiling, Editorial Assistant.
NEW YORK CITY, Dec. 19, 1898.
To the Editor:— In
response to my request for specific information about instances in
which the specialist has paid commission to the general practitioner
for referred cases, I have received several communications which
indicate that the practice is not uncommon in a section of our country
which is renowned for its "hustling" spirit. Personal inquiry among
representative members of the profession in New York convinces me that
my first impression was right, and that a division of the fee is never
likely to become a practice here, excepting in instances where the
patient agrees to pay a definite sum for the entire management of the
case. This is rare, and would be an openly conducted transaction. I am
in a position to see two sides of the matter. I have dropped from my
practice everything excepting operative surgery, but during the year a
good many other sorts of cases come in, which are referred to men who I
believe are best authority. If any one of these men had been in the
habit of offering a commission it certainly would have come to my
knowledge, and further, he certainly would never have another one of my
cases. On the other hand, I am constantly in contact with physicians
who bring cases from all over the country, and not one of them has ever
suggested that he would like a commission. As some of these physicians
have come from the commission-infected area, they must have lost the
symptoms on arrival in our atmosphere.
THE COMMISSION EVIL. JAMA. 1998;280(24):2121A. doi:10.1001/jama.280.24.2121-a
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