Since it was first established in 1913, the American College of Surgeons (ACS) has been a leading voice in opposition to fee splitting and other unethical practices among surgeons and other health care professionals. Indeed, to this day, Fellows pledge to “take no part in any arrangement or improper financial dealings that induce referral, treatment, or withholding of treatment for reasons other than the patient’s welfare.”
In March 1952, the U.S. Supreme Court ruled that the income tax deductions that two North Carolina opticians took for kickbacks to ophthalmologists on eyeglasses sold to their patients were ordinary and necessary expenses. The court maintained that because no public policy regarding these types of activities existed at the time that the opticians took the payments from the physicians, the court was forced to rule in the defendants’ favor.
The Supreme Court’s decision prompted the ACS Board of Regents to study the intricacies of fee splitting and to periodically issue statements defining and clarifying the College’s views on the matter. The first of these proclamations, “A Statement on Certain Unethical Practices in Surgery,” is reprinted in the following pages as part of the Bulletin’s commemoration of the College’s Centennial. The statement is preceded by an article describing the court case and the ACS’ response to it. These materials were published in the July–August 1952 issue of the Bulletin.