Medical ethics: rebates and commission: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Medical ethics: rebates and commission

Sample item

A general practitioner refers patients to a particular diagnostic laboratory, which pays him 20% of each bill. How is this practice regarded under the Indian medical Code of Ethics?

AAs acceptable, since the laboratory is registeredBAs professional misconduct, since rebates and commissions for referrals are prohibitedCAs a legitimate fee for the time spent explaining the reportDAs acceptable, if the patient is told about the arrangement

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. As professional misconduct, since rebates and commissions for referrals are prohibited

The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 prohibit a practitioner from giving or receiving any rebate or commission for referring patients to a laboratory, hospital or colleague, which is called fee-splitting or dichotomy. Such practice is professional misconduct and can lead to disciplinary action. Disclosure to the patient does not cure it.

Option by option

A. As acceptable, since the laboratory is registered
Registration of the laboratory has no bearing on the prohibition against commissions.
B. As professional misconduct, since rebates and commissions for referrals are prohibited (correct)
Correct. Commissions for referrals are prohibited and constitute misconduct.
C. As a legitimate fee for the time spent explaining the report
A payment linked to referral volume is not a fee for professional services.
D. As acceptable, if the patient is told about the arrangement
Telling the patient does not make a commission legal or ethical.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, As professional misconduct, since rebates and commissions for referrals are prohibited. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 prohibit a practitioner from giving or receiving any rebate or commission for referring patients to a laboratory, hospital or colleague, which is called fee-splitting or dichotomy.

Why is "As acceptable, since the laboratory is registered" not the answer?

Registration of the laboratory has no bearing on the prohibition against commissions.

Why is "As a legitimate fee for the time spent explaining the report" not the answer?

A payment linked to referral volume is not a fee for professional services.

Why is "As acceptable, if the patient is told about the arrangement" not the answer?

Telling the patient does not make a commission legal or ethical.

What concept does this question test?

It tests Medical ethics: rebates and commission in Forensic Medicine. Such practice is professional misconduct and can lead to disciplinary action. Disclosure to the patient does not cure it.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Medical ethics: rebates and commission?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.