The 2014 version of the American Counseling Association (ACA) Code of Ethics just came out. In this post, I will discuss fee splitting.
For those of you who don’t know, ACA defines fee splitting as: “Fee Splitting – the payment or acceptance of fees for client referrals (e.g., percentage of fee paid for rent, referral fees).” Wikipedia has a slightly different definition: “Fee splitting is the practice of sharing fees with professional colleagues, such as physicians or lawyers, in return for being sent referrals.” Therefore, any time that you receive some type of compensation for sending a client somewhere you are “fee splitting.”
Immediately you may think, well of course that shouldn’t be allowed, it sounds like a kickback and everyone knows those are unethical. But think more deeply about it and some sticky situations arise.
Consider the following: you run a group practice, which means you have an arrangement with some therapists to not only share physical space, but share marketing, administrative services, etc. For many, this can be a very lucrative way to run a practice, particularly if your therapists have different specialties. Consider it one-stop shopping for your client.
As manager of your group practice, you may decide to take on a therapist that is just starting their practice, and cannot afford to pay you a flat rate each month. So you decide that instead they will give you a percentage of what they earn from seeing clients. It’s worth the financial risk to you because this therapist has a specialty that no other therapist in your group has. This means all of the other therapists, including yourself, will refer clients who have that particular issue to that particular therapist. This is beneficial because everyone in your group practice has a very collaborative working relationship, so it not only benefits the client clinically, but it means they will return the favor and provide you with referrals. Everyone wins, right? Not only do you have a great business model but the service to the client improves.
Not so fast. According to the ACA, this is considered fee splitting and is unethical. According to the ACA ethics code, A.10.b: “Counselors do not participate in fee splitting, nor do they give or receive commissions, rebates, or any other form of remuneration when referring clients for professional services.”
In my next post, I will reveal what therapists are REALLY thinking, as well as the ACA’s response. Stay Tuned.
Yours in the Joy of Knowledge,
Dr. Barbara LoFrisco
