| Sunday, August 07, 2005 | ||||||||||||||||||||||
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A doctor, like any other human being who works for a living, deserves just compensation for his services. However, how much he should actually receive has always been a matter of controversy. There is no set standard which dictates how much a doctor should charge, so professional fees are pretty much arbitrary. The doctor can set them himself, factoring in his education, expertise and experience. Or, he can go by the standards of his colleagues, so that there is a semblance of fair play in the neverending competition for patients. But what exactly does "just compensation" mean? What else is someone supposed to factor in when computing the professional fee? How about improvement in the quality of life? How about the increase in the patient's lifespan? Are those ineffables considered too? The factor that definitely shouldn't be considered is the doctor's current financial status. The fact that he is building his house or dead set on buying a BMW shouldn't reflect on the patient's bill, right? Of course. But there are some supposedly professionals out there (who took the Hippocratic Oath along with the rest of us) who must think otherwise, judging by their actions. I know of a cardiovascular surgeon who had a patient referred to him by a general surgeon. For simplicity's sake, let's call the TCVS Dr. Lopez, and the GS Dr. Del Monte. The two doctors had been classmates back when they were still in Medical school, and were ostensibly friends. The patient, a retired seaman who had been experiencing intensifying chest pains, turned out to have advanced Coronary Artery Disease. He had savings from his lucrative former job, but the brunt of the expenses would be shouldered by his company. Dr. Lopez gave him the less expensive package at the hospital anyway, seeing that the patient was elderly and had no close family. The operation was a success. The patient was soon feeling perfectly healthy and pain-free. Grateful and delighted at the impeccable service, he asked for the bill so he could settle it and give the receipt to his company for reimbursement. Oddly, Dr. Del Monte asked his friend how much the package was, saying that he wanted to collect the money himself. Dr. Lopez gave a figure of 200,000 pesos, which was a fair price considering that this already covered the hospital fees for ten days' confinement and the fees of three other prominent consultants. A few days later, Dr. Del Monte approached Dr. Lopez again and gave him the 200,000 pesos in cash. He then asked for a receipt in return. For 350,000 pesos. Dr. Lopez was nonplussed. Why was he going to sign out a receipt for 350,000 when he had only received 200,000? That was not part of the deal. He asked for an explanation, which Dr. Lopez initially refused to give, saying that it was irrelevant. Finally, at Dr. Lopez's insistence, the whole story came out. Del Monte had charged the patient 350,000. Upon receiving the full amount in cash, he had then given the 200,000 to his friend and pocketed the rest as his 'professional fee'. Lopez was stunned. His 'friend' had not done anything to earn that extravagant sum. Del Monte was a general surgeon, and had not assisted in the patient's management in any way. He didn't even visit while the patient was in the hospital convalescing. Further questioning disclosed what Lopez feared. Del Monte was in the process of buying an expensive car which he didn't quite have the funds for. Perhaps he wanted the money for down payment. Of course, he wouldn't admit to such a thing, but he wouldn't explain why would charge so exorbitantly, either. Lopez maintained his stand. He would not issue a receipt for 350K when he had not received any such money, even for the sake of friendship; not because he was afraid of being caught, but because it was the wrong thing to do. He would not help perpetuate such an unethical practice. The comical thing was, this reasoning never occurred to Del Monte until Lopez spelled it out for him. Del Monte thought that his friend was refusing him out of either cowardice or spite. When he learned that it was out of integrity, he sputtered and completely lost wind. Evidently, he thought that most of his friends subscribed to or tolerated this form of self-enrichment, instead of doing honest work. He was wrong. To shorten a long story, Lopez never acquiesced to Del Monte's demands. He wrote a receipt for 200,000 pesos only. The GS eventually had to sign out his own receipt for the 150,000 pesos that he had pocketed, making his greed perfectly clear. As expected, the company did not reimburse this additional expense. The patient returned to the TCVS, fuming at his attending physician's treachery and hinting darkly of reprisal. Lopez never heard anything more about it after the last check-up. He hasn't heard from Del Monte since, either, after the latter suddenly and mysteriously left the country. So, on whose side would you be on? Would you have two different answers depending on whether anyone could hear you or not? It's easy to side with justice on the abstract. But if you were in the same situation, and you had to consider such factors as friendship, loyalty to the profession and your colleagues, maintaining appearances, and the possibility of a suit...it's nowhere near as cut-and-dried. That Dr. Lopez chose the right path anyway is a testament to his values, and a lesson to all of us who are striving to uphold the respect which comes with being called "Doctor".
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ABOUT ME:
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