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National Defence Trust
1021
PANEL AND CONTRACT PRACTICE The Panel Conference and After
IN the debate on certification it was stated that, whilst some societies never paid beyond the date of the medical certificate, others paid up to the day of the agent’s visit whatever the date on the certificate. This was risking surcharge by the Government auditor if the man declared off before the date of this payment, but
some
large
societies said
trouble of this kind
they never had any although they always took
the risk. The Insurance Acts Committee, after withdrawing the original paragraph on alternative occupations on the ground of infringement of professional secrecy, induced the conference to accept the suggested letter with the addition of a line indicating when it was thought a final certificate would be issued. It came out at the conference that the LA.C. had not discussed the question of professional secrecy with their legal advisors. The form is actually in use at the present time by some societies, but, in view of the fact that such procedure would not be adopted in private practice, insurance practitioners who want to avoid trouble would be well advised to consign it to the wastepaper basket, if and when it arrives. Alternatively, the consent of the patient might be obtained to report on his condition. It is not easy to see in what way this letter is preferable to reference to the R.M.O. Dr. Dain, chairman, said that two societies would not have anything to do with it on the ground of waste of time which might be occasioned in its use; they get the R.M.O.’s opinion in about four days. He seems to have spoken of "the unsatisfactory procedure of referring the patient to the R.M.O. himself" without explaining to the conference in what
respect
the
procedure
is
unsatisfactory.
Many
doctors are now doing this quite frequently in cases of doubtful incapacity with the full knowledge and agreement of the patient. The patient respects the doctor who says to him In your case it is difficult to decide how much longer you ought to stay on the funds. You see I have to be fair to your society as well as to you, I am therefore proposing to get the R.M.O.’s opinion about your condition. He will let me know what he thinks of your case." Such a procedure cuts away the ground from the agent who goes round telling the patient that it must have been the doctor who sent the case to the R.M.O., as the society did not. The procedure is fair to all parties, it is straightforward, and in conformity with the best traditions of private
practice. National Defence Trust
The latest
figures are satisfactory although London severely criticised at the conference for the small percentage of its contribution : 37 as compared with 57 by Middlesex. The explanation is that the
was
London committee subscribes to two funds, the national and that of the M.P.U., between which, in the absence of precise instruction, the money is equally divided. Last year sanction was given by the conference to spend part of the interest in helping
aged and infirm practitioners to retire, thus preventing harm to themselves and to the service. The outlay is not large, for these old people do not as’a rule live more than a was also
few months after retirement.
Sanction insurance helping practitioners in Llanelly who have suffered loss through resisting the proposals of the workmen’s committee. There is
given
to
some division of opinion as to what should be done with this fund. Some want to see the interest used for the benefit of the service, one suggestion being to give grants to research workers ; others would like all the interest to be added to the principal to increase the fund as a fighting force-at the moment it does not represent 4 per cent. of the total annual income of the service. Smethwick wanted to make certain that the older practitioners who have paid their quota should not be asked to continue subscribing simply for the benefit chiefly of younger men who do not subscribe. Some return, it was felt, should be made to the oldubscribers.
Partnership
with Non-Panel Practitioner
Lancashire asked the conterence to express the view that such a partnership was prejudicial to the observance of the regulations by leading to the receipt of fees by insurance practitioners from patients on their lists. Dr. Dain pointed out that a practitioner is not bound to disclose the fact that he is in partnership with a doctor not on the insurance list. This important subject has not been discussed at the conference for a long time. Take the case of Dr. N., not an insurance practitioner, in partnership with The question Dr. I. who is on the medical list. arises whether their surgeries are in separate houses or in the same building, whether they use the same surgery at different times for their consultations. There can be little cause of complaint if an insured person on the list of Dr. 1. consults Dr. N. at Dr. N.’s house when Dr. I. is himself available to be consulted, but if such a patient is sent by Dr. 1. to see Dr. N. then Dr. N. becomes the deputy of Dr. I. and there will presumably be grounds for complaint if a fee was charged by Dr. N. The position becomes a little more difficult for the patient if the two surgeries are in the same building, for new patients may not know either Dr. 1. or Dr. N. personally. In such cases some indication should be made as to which room is being used for the insurance part of the practice. There can, however, hardly be any excuse for Dr. N. charging fees to insured persons on Dr. I.’s list when both use the same room at different times for consultations. Obviously a patient who suddenly decides to see his insurance doctor will consider Dr. N. to be acting for the doctor of his choice if, when he arrives at the surgery he finds Dr. N. doing Dr. I.’s work. Dr. N. will of course not want to charge the insured person on Dr. 1.’s list if he recalls that he is already sharing in the payment made to Dr. I. for his contract. All these difficulties would straighten themselves out if insured persons were definitely told that when consulting a new doctor they should state that they claimed to be treated as an insured person. The position of Dr. N. is quite different when it comes to the treatment of insured patients who are not on his partner’s list ; for them he is quite free from any panel obligations such as emergency treatment or temporary resident work.
UNIVERSITY OF CAMBRIDGE.—It is announced that Sir Percival Horton-Smith Hartley, consulting physician at St. Bartholomew’s Hospital, has made over to the University for the further endowment of the Raymond Horton-Smith prize securities producing an income which will restore the former value of the prize. Sir Percival is the eldest son of the original donor and a brother of Raymond John Horton-Smith whom the
prize
commemorates.
PANEL AND CONTRACT PRACTICE The Panel Conference and After
IN the debate on certification it was stated that, whilst some societies never paid beyond the date of the medical certificate, others paid up to the day of the agent’s visit whatever the date on the certificate. This was risking surcharge by the Government auditor if the man declared off before the date of this payment, but
some
large
societies said
trouble of this kind
they never had any although they always took
the risk. The Insurance Acts Committee, after withdrawing the original paragraph on alternative occupations on the ground of infringement of professional secrecy, induced the conference to accept the suggested letter with the addition of a line indicating when it was thought a final certificate would be issued. It came out at the conference that the LA.C. had not discussed the question of professional secrecy with their legal advisors. The form is actually in use at the present time by some societies, but, in view of the fact that such procedure would not be adopted in private practice, insurance practitioners who want to avoid trouble would be well advised to consign it to the wastepaper basket, if and when it arrives. Alternatively, the consent of the patient might be obtained to report on his condition. It is not easy to see in what way this letter is preferable to reference to the R.M.O. Dr. Dain, chairman, said that two societies would not have anything to do with it on the ground of waste of time which might be occasioned in its use; they get the R.M.O.’s opinion in about four days. He seems to have spoken of "the unsatisfactory procedure of referring the patient to the R.M.O. himself" without explaining to the conference in what
respect
the
procedure
is
unsatisfactory.
Many
doctors are now doing this quite frequently in cases of doubtful incapacity with the full knowledge and agreement of the patient. The patient respects the doctor who says to him In your case it is difficult to decide how much longer you ought to stay on the funds. You see I have to be fair to your society as well as to you, I am therefore proposing to get the R.M.O.’s opinion about your condition. He will let me know what he thinks of your case." Such a procedure cuts away the ground from the agent who goes round telling the patient that it must have been the doctor who sent the case to the R.M.O., as the society did not. The procedure is fair to all parties, it is straightforward, and in conformity with the best traditions of private
practice. National Defence Trust
The latest
figures are satisfactory although London severely criticised at the conference for the small percentage of its contribution : 37 as compared with 57 by Middlesex. The explanation is that the
was
London committee subscribes to two funds, the national and that of the M.P.U., between which, in the absence of precise instruction, the money is equally divided. Last year sanction was given by the conference to spend part of the interest in helping
aged and infirm practitioners to retire, thus preventing harm to themselves and to the service. The outlay is not large, for these old people do not as’a rule live more than a was also
few months after retirement.
Sanction insurance helping practitioners in Llanelly who have suffered loss through resisting the proposals of the workmen’s committee. There is
given
to
some division of opinion as to what should be done with this fund. Some want to see the interest used for the benefit of the service, one suggestion being to give grants to research workers ; others would like all the interest to be added to the principal to increase the fund as a fighting force-at the moment it does not represent 4 per cent. of the total annual income of the service. Smethwick wanted to make certain that the older practitioners who have paid their quota should not be asked to continue subscribing simply for the benefit chiefly of younger men who do not subscribe. Some return, it was felt, should be made to the oldubscribers.
Partnership
with Non-Panel Practitioner
Lancashire asked the conterence to express the view that such a partnership was prejudicial to the observance of the regulations by leading to the receipt of fees by insurance practitioners from patients on their lists. Dr. Dain pointed out that a practitioner is not bound to disclose the fact that he is in partnership with a doctor not on the insurance list. This important subject has not been discussed at the conference for a long time. Take the case of Dr. N., not an insurance practitioner, in partnership with The question Dr. I. who is on the medical list. arises whether their surgeries are in separate houses or in the same building, whether they use the same surgery at different times for their consultations. There can be little cause of complaint if an insured person on the list of Dr. 1. consults Dr. N. at Dr. N.’s house when Dr. I. is himself available to be consulted, but if such a patient is sent by Dr. 1. to see Dr. N. then Dr. N. becomes the deputy of Dr. I. and there will presumably be grounds for complaint if a fee was charged by Dr. N. The position becomes a little more difficult for the patient if the two surgeries are in the same building, for new patients may not know either Dr. 1. or Dr. N. personally. In such cases some indication should be made as to which room is being used for the insurance part of the practice. There can, however, hardly be any excuse for Dr. N. charging fees to insured persons on Dr. I.’s list when both use the same room at different times for consultations. Obviously a patient who suddenly decides to see his insurance doctor will consider Dr. N. to be acting for the doctor of his choice if, when he arrives at the surgery he finds Dr. N. doing Dr. I.’s work. Dr. N. will of course not want to charge the insured person on Dr. 1.’s list if he recalls that he is already sharing in the payment made to Dr. I. for his contract. All these difficulties would straighten themselves out if insured persons were definitely told that when consulting a new doctor they should state that they claimed to be treated as an insured person. The position of Dr. N. is quite different when it comes to the treatment of insured patients who are not on his partner’s list ; for them he is quite free from any panel obligations such as emergency treatment or temporary resident work.
UNIVERSITY OF CAMBRIDGE.—It is announced that Sir Percival Horton-Smith Hartley, consulting physician at St. Bartholomew’s Hospital, has made over to the University for the further endowment of the Raymond Horton-Smith prize securities producing an income which will restore the former value of the prize. Sir Percival is the eldest son of the original donor and a brother of Raymond John Horton-Smith whom the
prize
commemorates.