Ethics of billing: determining one's value

摘要

Costs of medicine and fees in private practice are topical as ever with pressure from all sides to make care affordable to all. Many see specialists as cost drivers and excessively remunerated, yet many specialists are unhappy with their earnings. Unless surgeons earn adequately, their service will reduce. The conflicts of financial reimbursement and professionalism are discussed along with the history of billing in medicine. Using the state salaries as a basis, equivalent private practice turnovers are calculated demonstrating the vast difference between perceived earnings based on turnover and the real earnings of the surgeon. An individualised tariff calculation is recommended along with appropriate billing practice. This paper is based on an ethics lectured delivered at the 2010 South African Spine Society meeting in Cape Town.