III. INTERPROFESSIONAL RELATIONS
A. Surgeons and Colleagues
The surgeon’s relationship with colleagues is often an
important part of ensuring the best care is provided
to the patient. No single physician or surgeon can be
an expert in all areas of medicine. Team medicine has
become the norm, and surgeons have a responsibility
to work with colleagues.
Surgeons who have intimate personal relationships with individuals at their workplace should seek
to minimize their supervisory responsibilities with
those individuals and should excuse themselves from
the evaluation process.
B. Discrimination or Harassment
The ethical practice of medicine establishes and ensures
an environment in which patients, staff, colleagues,
students, residents, and all other individuals are treated
with respect and tolerance. Discrimination, harassment, or creation of a hostile working environment
on the basis of personal attributes, including but not
limited to age, sexual preference, gender, race, disease,
disability, or religion, is inconsistent with the ideals
and principles of the American College of Surgeons.
The surgeon is responsible for obtaining consultation
for his or her patients when appropriate, and for providing consultation for the patients of colleagues when
requested. These consultations may be for opinion
only, to assist with management, or for the transfer of
care. The patient should be informed in any instance
that requires such a consultation. An appropriate
report that is, by letter or by placement in a common
chart or medical record, should be made available to
the referring physician.
Payment of any kind, or by any method, by the sur-
geon to a referring physician to induce referral of a
patient (fee splitting) is unethical (and usually is illegal).
Although a number of practices and procedures that
represent modified and subtle forms of fee splitting
now exist, surgeons are responsible for recognizing
and avoiding them.
Payment to another physician for required assistance that is provided at operation may be made
properly to that assistant by the patient. The patient
should be informed of the nature and amount of the
payment. The means and mechanisms of such payment
may be dictated by certain contractual obligations of
the patient and the surgeon.
E. Relationships to Nonphysicians
Dentists, podiatrists, and chiropractors are on staff at
many institutions and may ask a surgeon to assist in the
management of their patients. The surgeon, as always,
must be guided by the overriding principle that the
patient’s best interests are to be served.
Many oral surgeons possess MD and DDS degrees, and
dental surgery has expanded to include maxillofacial
surgery. In the care of patients with injuries or lesions
that involve complicated dental surgical problems, oral
surgeons may be an essential part of the surgical team
and may act independently in the area of their special competence. In the hospital setting, oral surgeons
and other dentists may be included as members of the
department of surgery.
In many hospitals, licensed podiatrists may admit
patients in collaboration with physicians who will
assume responsibility for the overall care of the patient.
Such an arrangement must be under the supervision of
the collaborating physician, with the type and extent
of their operative procedures determined by the institution’s credentialing process.
The American College of Surgeons declares that, except
as provided by law, there are no ethical or collective
impediments to full professional association and coop-
eration between doctors of chiropractic and medical
*Adopted pursuant to settlement agreement in Wilk et al v. AMA et al,
September 1987. See the Appendix for full text.