Book contents
- Frontmatter
- Contents
- Illustrations
- Preface
- Chapter 1 Early Days
- Chapter 2 Washington Heights
- Chapter 3 Speyer School for Gifted Children
- Chapter 4 New York University at University Heights
- Chapter 5 To Each His Farthest Star–A Medical Student at Rochester: 1929–1934
- Chapter 6 Duke University Hospital and Its Medical School, 1934–1935
- Chapter 7 Yale Medical School, 1935–1936
- Chapter 8 Return to Duke, 1936-1937
- Chapter 9 You Can Go Home Again
- Chapter 10 My One and Only Wife
- Chapter 11 The Bronx Is the Graveyard for Specialists, 1937
- Chapter 12 The Columbia-Presbyterian Medical Center, 1937 — The First of Its Kind
- Chapter 13 Pearl Harbor and World War II
- Chapter 14 Valley Forge General Hospital, 1942–1945
- Chapter 15 Tinian, 1945
- Chapter 16 Saipan, 1945–1946
- Chapter 17 Return to Columbia-Presbyterian, 1946
- Chapter 18 The Changing of the Guard at the Medical Center
- Chapter 19 An Internist-Diagnostician Rebuilds His Practice
- Chapter 20 The Upjohn Grand Rounds
- Chapter 21 The Iceman Cometh to Park Avenue
- Chapter 22 Songs My Patients Taught Me
- Chapter 23 Mr. J. Peter Grace, Chairman of W. R. Grace and Company
- Chapter 24 Birth of the Upjohn Gastrointestinal Service
- Chapter 25 Roosevelt Hospital, 1962–1965
- Chapter 26 Consultant and Physician to President Herbert C. Hoover
- Chapter 27 Problems at Roosevelt Hospital: The Bête Noir of Full Time
- Chapter 28 Internal Medicine as a Vocation (1897)
- Chapter 29 The Upjohn Service Moves to St. Vincent’s Hospital
- Chapter 30 Helicobacter Pylori and Peptic Ulcer: A Revolution in Gastroenterology
- Chapter 31 Plasmapheresis for Hepatic Coma at St. Vincent’s Hospital
- Epilogue
- Endmatter
Chapter 11 - The Bronx Is the Graveyard for Specialists, 1937
Published online by Cambridge University Press: 17 March 2023
- Frontmatter
- Contents
- Illustrations
- Preface
- Chapter 1 Early Days
- Chapter 2 Washington Heights
- Chapter 3 Speyer School for Gifted Children
- Chapter 4 New York University at University Heights
- Chapter 5 To Each His Farthest Star–A Medical Student at Rochester: 1929–1934
- Chapter 6 Duke University Hospital and Its Medical School, 1934–1935
- Chapter 7 Yale Medical School, 1935–1936
- Chapter 8 Return to Duke, 1936-1937
- Chapter 9 You Can Go Home Again
- Chapter 10 My One and Only Wife
- Chapter 11 The Bronx Is the Graveyard for Specialists, 1937
- Chapter 12 The Columbia-Presbyterian Medical Center, 1937 — The First of Its Kind
- Chapter 13 Pearl Harbor and World War II
- Chapter 14 Valley Forge General Hospital, 1942–1945
- Chapter 15 Tinian, 1945
- Chapter 16 Saipan, 1945–1946
- Chapter 17 Return to Columbia-Presbyterian, 1946
- Chapter 18 The Changing of the Guard at the Medical Center
- Chapter 19 An Internist-Diagnostician Rebuilds His Practice
- Chapter 20 The Upjohn Grand Rounds
- Chapter 21 The Iceman Cometh to Park Avenue
- Chapter 22 Songs My Patients Taught Me
- Chapter 23 Mr. J. Peter Grace, Chairman of W. R. Grace and Company
- Chapter 24 Birth of the Upjohn Gastrointestinal Service
- Chapter 25 Roosevelt Hospital, 1962–1965
- Chapter 26 Consultant and Physician to President Herbert C. Hoover
- Chapter 27 Problems at Roosevelt Hospital: The Bête Noir of Full Time
- Chapter 28 Internal Medicine as a Vocation (1897)
- Chapter 29 The Upjohn Service Moves to St. Vincent’s Hospital
- Chapter 30 Helicobacter Pylori and Peptic Ulcer: A Revolution in Gastroenterology
- Chapter 31 Plasmapheresis for Hepatic Coma at St. Vincent’s Hospital
- Epilogue
- Endmatter
Summary
My practice in the bronx was keeping me very busy and I was learning lots of things they had never taught in medical school. The first unpleasant experience was to find that virtually all of the doctors I encountered were splitting fees and accepting kickbacks. A specialist would charge the patient a fee and then split it with the referring doctor. A surgeon would operate and split the fee with the family doctor. If you called a private ambulance for a patient, the ambulance company would kickback a portion of their fee. If you ordered a back brace or a truss for a patient, the surgical supply firm would kickback part of the fee. I knew this was wrong and I didn't have to take a course in medical ethics to be certain this was unacceptable. I remember how embarrassed I was when I accompanied one of my early patients for an ENT consultation on the Grand Concourse. The specialist tried to slip a few dollars in cash into my pocket as I left his office. I returned these on the spot like a hot potato and told the doctor that I did not split fees. I never sent him another patient. On another occasion, a check for ten dollars arrived in the mail from an ambulance company. It was promptly sent back. A similar check from a surgical supply house for a back brace was returned by the next mail. Both checks were accompanied by a short letter saying that I did not accept these “referral” fees and suggested that they charge my patient less.
To my chagrin, I soon found out these practices were rampant in the Bronx and presumably elsewhere. When I discussed this with some of my colleagues, various explanations were offered. Times were tough and they needed every dollar they could get to meet their expenses. They said everybody was doing it. Some would later, when they were financially better off, deny that they had ever split fees. Others would claim it was merely another legitimate business expense that served to steer patients to them.
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- Information
- The Life of the ClinicianThe Autobiography of Michael Lepore, pp. 141 - 148Publisher: Boydell & BrewerPrint publication year: 2002