Fee Splitting among General Practitioners: A Cross-Sectional Study in Iran.

Area of Science:

• Medical Ethics
• Healthcare Policy
• Physician Behavior

Background:

• Fee splitting involves physicians referring patients for a share of the fee.
• This practice raises ethical concerns within the medical profession.

Purpose of the Study:

• To investigate general practitioners' (GPs) attitudes towards fee splitting.
• To determine the prevalence, causes, and consequences of fee splitting in Iran.

Main Methods:

• A cross-sectional study involving 223 general practitioners in 2013.
• Qualitative interviews informed questionnaire development on causes and consequences.

Main Results:

• 69.1% of GPs deemed fee splitting unethical, yet 23.2% practiced it.
• Positive attitudes correlated with higher prevalence (4.63 times more likely).
• Unfair tariffs were the main cause; unnecessary referrals the main consequence.

Conclusions:

• Fee splitting is an unethical practice undermining patient interests.
• Despite majority disapproval, practice exists, influenced by tariffs.
• Revising healthcare tariffs is recommended to reduce fee splitting.