ECHO OF EPIDEMIC

Dominion, Volume 13, Issue 37, 7 November 1919, Page 2

ECHO OF EPIDEMIC

A DOCTOR'S CHARGES

WERE THEY EXCESSIVE?

At the Magistrate's Court yesterday Jlr. W. G. .Kiddcll, S.M., was asked to decide whether the charges made by Dr. Faulke for visiting patients at "Eastbourne during the late inlluenza epidemic were yteessiye. Tli<; case arose out of (he non-payment of an account rendered by Dr. 'Faulko for l'-l fe for two visite to the sun of A. W. Press, of Eastbourne, who conlended that the doctor's charg? wad excessive, and who had offered ,£2 2s. in full settlement of the account. Dr. Faulko would not accept this, and took action for the recoyery of the full amount. Mr. 11. P. von Hafyst. appeared in support of the claim, and Mr. If. Kennedy defended. ■ "£2 2s. Not Unreasonable," In outlining his case, Mr. von Haast said that during the epidemic Dr. Faulke attended the defendant's son on two occasions. and charged ,£2 2s. for'each visit. His client was a qualified practitioner who specialised in surspiy. When the epidemic gradually grew'wwso Dr. Faulke was urged to devote his timo to the Eastbourne residents, as no other doctor was available. This he did, and as a result '.had to neglect his city practice and also his surgical work. There was no question of fees chargeable in ordinary times, as the fee for a doctor to go from lower Hutt to e. patient at' Eastbourne wlas ,I*2 2s. Whilst at' Eastbourne ho nftended IfiO cases in all. and it was some testimony to his skill that not one, of these patients died. The Eastbourne Epidemic Committee sent Dr. Paulkc a letter, in which they eulogised bis.efforts and valuable assistance, ami expressed gratitude for his work during Ihe trying time: -He was engaged at Eastbourne for a period of four weeks, atul the Gov; eminent paid 'him ,£7 7s. per diem for Mirco weeks, la total of .£154 7s. Tie was also paid ,£-12 for motor allownncf. During that period of four weeks lie received from his regular patients ',£-14 25., and from other patients n siim of ,i'ol 4s. As a result of . being engaged at Eartbourne almost exclusively for tho four weeks 'his town ,practice, hecnuio disorganised, and it, was not till February of this year that it bccamc normal again. The defendant ftas' .a man in a good portion, and there was no question', of him not being able to pay. Tho charge <jf £2 2s. was not uiiroa--onablo. The plaintiff'stated that lie had been in nr.ietiie since JBbS, and he had heeii in Wellington for twenty-'ive'years. He snecialist-d in surgery. His average number of operations was seven a month, and this he lost during the epidemic. , He attended the defendant's son twicc, ■and advised. He charged £2 2s. <for each visit. Ever since there had been a settlement at Eastbourne he had attended patients there, and his minimum charge had always been ,£2 2s. Ho commenced' work at Eastbourne on November 11. The Eastbourne Epidemic Committee requested plaintiff to remain in 'Eastbourne and devote his efforts, thero. He consented, and remained there till December 7, He attended the. hospital there. His town practice did not return to normal till March. He attended 160 cases at Eastbourne. He had never heard of any <ioc.tor making reductions in his fees by reason'of tlio number of Tfitioiit.s ho wi's attending.. Ho was through earlier epidemics in England, anil had never heard .of. any reductions in fees for such u reasqn. Government's Grant and plaintiff's Fees. J To Mr. Kennedy: Witness admitted j that the city was practically closed up j during the epidemic, ana' in nddition to I giving their services gratuitously for | tho benefit of the community, many business men were losing their profits. He was not allocated any block because lie declined for , the reason that lie was too husv with his Eastbourne patients. lie could not say whether or not during tho epidemic surgery patients were offering. On the lirst visit to defendant's : son ho was not there more than fifteen minutes, bit lie did all that was necessary. On the second visit he was not more than ten minutes in the house. . He charged .£2 2s. for each of the visits. He ditf not charge all the patients .£2 2s„ it depended on the patients' circumstances. The usual charge payable to a physician for a visit} was 10s. fid. throughout. New Zealand. This sum did not include mileage. For the period no.was at the Bay he received .£7 7s. per day from the Government, ulus ,£2 2s. per day motor allowance. These amounts were for three weeks, but he worked another wefk. and was not- paid,. Ho did not send out any epidemij accounts I'll he received ravmeilt from the Government. It would not be fair to say that notwithstanding the amounts he received from tho Government lie still charged patients £2 25./n visit, whilst, other doctors with a smaller number of patients were content to accept 10s. (id. Prior to the Government grant being made-representations-..were made to. the Government that rlaintiff had not chnrg. cd for-v.isih to individual, naticnts. These representations were contained in a letter from Mr. A. Walker respecting payment for Dr. Feulke's services, which should bp mckoned as covwinsr a neriod of four weeks. Ho was only paid fer . three weeks. Notwithstanding ivbat be had already received from the Government, he had rendered accounts totalling ,£375 4'. (id. for services rendered during the 27 days he was at Eastbourne. Mr. Kennedy:' What was the ,£7 7s. n dav for? . Plaintiff: That was Ihe Government's view of the worth of attendance on necessitous and hosnital cases. Continuing, plaintiff said that out o f Ih" IGO cases lie had attended lie had onlv rendered thirty-nine accounts. Counsel proceeded, to! nsk witness, for details as to his earnings during the onidemic period and. for an ordinary year, but <">uns°l fov the plaintiff objected, and the Magistrate 'uphold the objection. Mr. Kennedy remarked that des'red to prove the ulainliff's earnings had boon enormous. Plaintiff: And at great expense. ' The Moistrate: It must'be-remember-ed that the' coalitions were abnormal. Mr. K"nn'edy: Defendant, sent von a irnii-eas for cftch visit?—" Yes, some time alter." Do you know why the residents of Komi Bav. Eastbourne, and Day's Bnv am not naying Their -accounts?—"l do not know.'' ■ Do you know that they iook upon this a lest ease?— 1 "T- do not." You vourself look upon this a? a test case?—" Now T do." Other docWs and nurses n»ade "0 elier(;p for their. oprvices during t.'io enideniie? — r 'f don't what other doctors or nurses otc doinc." You know that tV. vz-'idcls if lh os * districts eomnlain that the charges were exorbitant?—"T have received no complaints from any of the residents." The i\Vn7islrale: Su"'inse vou nia' - '.' cjrml trips, to ]hy t what nv? tho . ;i nn! —"Thoy vary fi'fliii to rf"you lnnd* visits to «pvern! patients in (lie ww locality wom](l von * r-nluwl <'lHrsrp?~' f Xo. I wonld cousnler thn cnpcinl of tho '1'1,,. f.lt.M-crp nf In-;) rrniws tlio Qpn a n ' ! would 1)?' in all l)r ii» t)rncti^ A nt.ilio T o'yor TTutt. «nul Mint tho 'for r. vi-U to h'.w f'° ?p. \ Innil visit: wouM 6 1 ]. To h'onnpilv, th'it w 1,0 vi'shM at D'lv'-I B"v l:h«' charge for a j,,,,.,'} ,-..,> i i,n 10s. lid. ' .\ri--hil"M Wnlkc. I.loyds snrveyo- and -snd. w.T c'-'ii rf F'"'i, r „vM', r'.-ude— i" r"!n l " : llee. 'aid- I 1'"!' n.. ' y.-.-.-V ot Hie B,v. ''''d w' ? s ''"pei-'lr |lr"kfd bv the f"'' hi '-IT'-- 1 :. T t ires never ~,„lpr=tr--d t 1 '" 1 the'i-'-inftT wi- "»l I"" , VI , {~!■ hi-> services, end Ihet ""is for 1 et( T)r. Fmi'kn rr-freiiKd from ill" el r.iip-l I 1" tho ro'nniil'e.i li-iil n-c"'-i. :..„.i tlio ("lovcrnm?nl intended to d". "Foes Unrcasonablcj, Exeessivo, and Exorbitant." , For the dclVii' c, 3Jr. Kennedy «a!d that the. ca-e was defended as a mutter of ' piinciple. Tho defciidant resisted Ihe i-lnii.se l:.'«!ii-e h» Ixdievcd., ami counsel expi'e.-A'd the opinion o; Cho' residents i at the Day, tihat the charijo was unreasonable, excessive, and exorbiiant, undor

the circumstances. Counsel proceeded to explain the Bet-back business roceivod during the epidemic, mid the creation ot tlio block system, nud stated tliut tlio plaintiff, although not allocated under the Mock 6ystem, ho by arrangement allocated liiinsa'f to Eastbourne. Mr. von Ilaast: It is not fair for dy friend to say tlvat! 1 Jlr. Kennedy: Well, I will put it this way: Dr. Faulko became a practitioner practising at Eastbourne during the epidemic. Continuing, counsel said that tlio two attendances were of very short duration, and were made when the plaintiff was visiting other patients in close proximity to defendant's house. Ho submitted, under tlio circumstances, that £1 2>:. in respect of each visit was. not fail'—it, was a wholly unreasonable, excessive, and exorbitant fee. When the defendant received the account he sent tho plaintiff .£2 2s.—a guinea for each visit—as ho was advised that it was a fair tiling. Not only had tho defendant- charged in respect of patients attended by him, but he had received from tho Government. »n his owji admission, £1 7s. per day for a period of twenty-ono days for attendance, and ,£2 2s. « dayrmotor aT.owanee. Was it fair, asked counsel, that Dr. Faulke should receive a 6um of ,1190 7s. for his attendance for twenty-one dAys, which was at the rate of £3500 per annum, or ,£2BOO, cxeliiding,tlie motor allowance? It slholild l)e remembered that the patients Were all blocked together, and ■K2 Us. for each patient could not be held a reasonable fee. Kaintiff had admitted that in addition to the XI9G lie had received from the Government he had sent nut accounts for .£275 4s. fid., which made a total of £170 odd, which for tlio period worked out at tho rate'of ,£'7ooo a year. Deducting .£I3OO for bad debts, this would make the figure ,£5300 for the. year. At th : s rate plaintiff's fees would pay the salaries of the Chief Justice, and tour Judges of tlio Supreme Court,-concluded counsel. Tho defendant, Arthur Wm. Pros?, who l'psides at Day's Bay. said that-in sending Dr. Faulke a cheque for .£2 2 s . he considered this more than re.if«mal)lo under the circumstances, and explained, in the course of a letter, that the fco asked for was exorbitant. Arthur Maurice Andersun, public accountant', gave evidence as to preparing a financial statement from Dr, Pmilko's books as to his earnings during tho epidemic. and what they would represent for a vear. .'•■■■ Mrs. 11. M. Padclilro, who reside"! at R6na Bay, said that the plaintiff i visited her once, olid charged ,£i -Is., while the usual fee was only Ids. Od. On tho occasion of plaintiff's visit he was not in tho house more than ten minutes or it quarter of an hour. Francis John Ch'ttick, Paul Corliss i Peters, and Arthur Mi'mro. residents of | Enstbourntf. also gave evidence, and said j that the charges made by Dr. Faulke i during the epidemic period were con- j siderably 'in excess of those made by I other doctors- who had Attended them. 1 Recalled, Dr. Faulke said that he made j three visits to Mrs, T?adc!iffe's house-. He ; recalled that lie paid at leasl two visits j to tho house, but his diarv showed that j three visits had been made. j Magistrate's' Decision, In delivering his decision His Wor | ship said that the conditions which pievailed at the time were extraordinary and abnormal. According to the evidence Dr. Faulke was i attending to the whole of the influenza patients an well as other patients at Eastbourne. A great deal of evidence had heen given as, to tho amounts paid by the Public Health Department in connection with attendance on influen&a patients and the amount of the fees of doctors. In specific cases these fees had been considered as exeessivo partly for the reason (hat the doctors received a considerable sum of money from the Health Department. The foundation of t.hi- Act. was one of -contract between the defendant find the plaintill, and the question was whether tho amount charged by the plaintill' was exorbitant. There might be a oifference in urofessional charges, and the person who was dissatisfied had the remedy—he might, either contest it, -or pay the account and not engage the samo doctor again. In the present case the defendant. objected to pay the account on principle, and His Worship agreed that in taking the circumstances into consideration one could the fee a high one, especially in view of the fact that in general cases the charges were 10s. fid. Dr. Faulko had stated that if he was called to Rona Bay in the day time his fee would be- ,£2 25., and an urgent call would be .£'s 55., or at night time tho feo would be ,£lO 10s., and so on. In fixing their charges, doctors, including liio plaintiff, had no hard-am.'-fast rule, and it v;as necessary to take the individual circumstances into consideration. This was supported by the list of accounts rendered by the plaintiff. In one case a single visit was charged J22 25.. two visits Ji-l.'ts.'; and in another case .£1 ts. was charged fo"' four visits. The defendant's counsel had stated that the fees wore exorbitant, and by a calculation had shown (hat tho plaintiff would be receiving ■ a very considerable sum if he were paid tho amounts he demanded. That foundation was not sound, for the simple reason that the neriod \ms an extraordinary one, whichmight or might not recur. There were other factors taken into consioeva'.ion by the defendant, namely, the amount paid bv the Government to the doctors, and the knowledge ho had of the fees paid bv other patients. However, this was not. a sound ground for saying that the foes charged were exorbitant, but the fact that the Government had paid the plaintiff his motor allowances was a factov which should be taken info consideration in fixing the fee. Strictly speaking. one old not on re to interfere wilh am-' practitioner's or professional man's fees, for as a rule they had a scale to work on. It was very difficult to say whether the charge was an unusual one wlijeh should not be made under the ciri enmstances. Looking at Ihe matter in,n ireiieral iv.iv. Hie Worship was inclined to snv that for the 'first vHt the -fee' of 2s. wn-s « reasonable'one. but for the second' visit, he thought l that another .£2 2s. was unreasonable, and he nroposed to reduce the fee* eb-vged by one guinea' on that ground. Judgment was given for the plaintiff for jC.I 3s. and costs ill Ss.