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A Journal on Forensic Medicine
Minerva Medicolegale 2007 September;127(3):189-95
The medicolegal physician’s fees. Part 2. The opinion of the Union
Palombella A., Malavenda P.
Since the 1970s, the Italian Union of Medicolegal and Insurance Physicians (Sindacato Italiano specialisti di Medicina Legale e delle Assicurazio-ni, SISMLA), a free, independent, non-partisan non-profit association of physicians specialized in legal and insurance medicine, has been working “to protect the professional and cultural interests of sector operators.” Hence, the association “represents and promotes” the interests of its members within the Federation of Physicians’ and Dentists’ Associations, the Provincial Associations of Physicians and Dentists, the Associations of Physicians’ Unions, as well as all other public and private organizations “where such representation is necessary and appropriate.” Medicolegal activities can only be performed by individuals who have acquired specific skills, preferably through specific postgraduate training. Just as with other medical professionals, so too the medicolegal physician, with a view to protect the best interest of a party, whether public or private, should be attributed the precise and exclusive role of the highest guarantor in performing his/her specialized services. SISMLA, as represented by the National Secretary, has repeatedly approached the Ministry of Justice to make plain the various issues and criticalities the medicolegal professional contends with in the various sectors of its activities, illustrating the role and function that the medicolegal physician has in evaluating personal injury and in civil and criminal cases for which he/she is retained as expert witness. Driven by the initiatives of the National Secretariat and Provincial Secretariat of Rome, the debate on a new bill of law regulating the role of the medicolegal physician has been intensifying in an expression of the ineluctable needs of institutions and citizens. Moreover, there are equally important criticalities concerning the professional fees in the various areas where the medicolegal physician practices, as well as issues concerning legislation that would abolish minimum rates and introduce a free market system, VAT on health care services for medicolegal purposes, and sector studies. On a national level, the Union has opportunely moved through the appropriate channels to tackle individual problems and to provide support for overcoming them. On the provincial level, the Provincial Secretariats, in a strategy to defend the quality of specialist consultant services and to meet the public’s needs and expectations, have given indications, both clear and well-founded, regarding professional fees considered commensurate with the consultancy services requested and delivered, and in conformity with the provisions of the Medical Deontological Code (December 2006) regarding this question, actively involving the Provincial Association of Physicians and Dentists and having illustrated the rates schedule, in order to obtain an authoritative opinion on the setting of fair fees.