The doctor-patient relationship is at the heart of the practice of medicine. The trust a lay person places in a medical practitioner is almost an act of faith. That is why the community expects the profession to see that its members uphold the highest ethical standards. A recent finding of misconduct against a private specialist who overcharged an elderly patient is a case in point. Doctors, however, are up in arms about it. What sets the decision apart is that it is a landmark case that touches on doctors' right to set their own fees. They are not defending the colleague in question, but claim that the ruling by the Medical Council is dangerous because it does not define 'excessive charges'.
The council's disciplinary committee reprimanded the specialist after it found he overcharged for laboratory tests for financial gain. He billed the patient HK$2,780 and HK$1,400 for two sets of tests for which laboratories charged HK$1,400 and HK$175. There can be little argument about the overcharging. Filling in an order form for tests is not that different to writing out a prescription.
But that is not the way many doctors and their professional body look at it. Ten of the 28 members of the Medical Council have called for a review of the ruling. The Hong Kong Medical Association fears that it could leave doctors exposed to disciplinary action for charging high fees for professional skills and services because it fails to define 'excessive charges'.
The Medical Council's code of professional conduct on fees has regard for the difficulty, costs and special circumstances of the services performed and the time, skill and experience required. That would seem to be a framework that leaves doctors reasonable scope to set their fees without fear of being deemed to have overcharged.
Private doctors have every right to set their own fees in a free market. But the Medical Council has got it right when it says that they must set out their charges clearly, honestly and transparently on request, without any hidden elements, and, if they are substantial, do it in advance. Patients are entitled to be informed, and to have an opportunity to go elsewhere if they think the price is too high.