BHP ROLE PLAY: ETHICS OF REFFERING PATIENTS

Mrs. A (40 yo) was diagnosed by dr.B, a general practitioner, as having appendicitis which require surgery. Dr. b then reffered her to dr. C, asurgeon in a hospital. The husband,Mr. A asked dr. B if she can be reffered to dr. D instead. Dr. D was known as a good surgeon that also work in the same hospital. Dr. B said that he knows both of the surgeons but prefers dr. C because they can collaborate better after surgery. Moreover, dr.C said if Mrs. A insisted to be reffered to dr. D, he won’t take any responsibility if there is anything wrong with the surgery. Afterward Mrs. A agrees to be operated by dr. C. After dr. C left the room, she overheard a nurse said to her collague that dr. B is ‘in group’ with dr. C. He always send his patient to dr. C and receive money from him, known as ‘fee splitting’. Mr. A, the husband, said to her that he felt a suspiscion and felt mistrust to dr. C. who knows that the diagnosis was made up in order to be able to send a patient to the surgeon, so he can receive extra fee. The two then decided to change to another hospital.


Grup discussion

An overview of reffering a patient. Give case example of accepted practice in reffering a patient for each of the following situations:
-A general practitioner refer a patient to a specialist
-A general practitioner refers a patient to a another general practitioner
-A specialist refers a patient to a specialist from different field of expertise
-A specialist refers a patient to a specialist from the same field of expertise
-A specialist refers a patient to a general practitioner
-A general practitioner / specialist refers to an expert in non-medical field

Who should decide to which doctor the patient should be referred to?

An overview of ‘fee splitting’ in medical practice. Is it ethical aor unethical to give your collague doctor a fee after they refer you a patient? Give arguments!