French surgeons accused of fraudBMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6967.1464 (Published 03 December 1994) Cite this as: BMJ 1994;309:1464
Thirty French orthopaedic surgeons are being investigated for allegedly having swindled the social security's health insurance branch by receiving kickbacks for prescribing hip prostheses. Twenty two separate complaints have been lodged by regional branches of the “Secu” after a lengthy investigation showed the existence of a company that overcharged for prosthetic devices and paid doctors a percentage of the inflated sales prices.
The investigation was led by Maurice Dachary, director of the health insurance branch of the administrative district of Le Mans, west of Paris. It has already led to charges of fraud against three surgeons and against Patrick Cruchet, administrator of a company, Prolig, founded in 1987 to distribute prostheses.
Prolig or its subsidiaries organised congresses and so called research trips and paid doctors royalties for “research.” The investigation found that no research had been carried out and established a strong correlation between payments to doctors and the sale of prostheses to the private clinics where they practised.
A judicial expert's accounting report states that during these five years Cruchet paid himself a salary of Fr20m (pounds sterling 2.4m) and that his family withdrew about Fr78m (pounds sterling 9.4m) to purchase property (including a clinic), for travel, and for other personal expenses. According to the report, Fr34.5m (pounds sterling 4.1m) went into general expenses, which included payments of a total of Fr15m (pounds sterling 1.8m) to doctors.
The fraud is believed to have cost the Secu more than Fr100m (pounds sterling12m) over the five years ending 1992. Hip and knee prostheses were then placed on a health tariff limiting their price. Revealing details to the press, Dachary called for all prostheses and artificial implants to be placed on a government price control list.
Trials of the 30 doctors are expected to take place early next year. The French Society of Orthopaedic and Trauma Surgery has said that it will expel any doctors who are found guilty.
Another example of the crackdown on fraud has been an additional 50 complaints, forwarded to public prosecutors by the General Directorate of Fair Competition and for the Repression of Fraud, concerning violation of laws forbidding doctors to receive any form of payment or gift for prescribing orthopaedic apparatus or pharmaceuticals. Most of the 50 doctors are surgeons specialising in orthopaedics, ophthalmology, and otolaryngology.