The suspension of a doctor in northern China’s Shanxi province for helping a patient make an under-the-table payment to a visiting expert triggered an online discussion over the weekend about whether medical practitioners should accept such “service fees.”

Wang Bao, director of the neurology department at Hongtong People’s Hospital in the city of Linfen, delivered the 10,000 yuan ($1,400) service fee on behalf of a patient in need of a complex surgical procedure to an expert surgeon visiting from Beijing, according to media reports. The patient, Han Chunlin, had handed the cash to Wang before the surgery with instructions to give it to the expert, surnamed Song.

So-called service fees are meant to cover visiting doctors’ expenses, including travel and accommodation. Patients and doctors typically agree upon the amount beforehand.

Healthcare facilities that invite outside medical experts to diagnose and treat patients should pay their employers, rather than compensate the experts directly, according to national policy. Rules also forbid doctors from taking money directly from patients, and all expenses incurred during a visit must be recorded by both their host and home institutions.

A county doctor from Hongtong told Sixth Tone on Saturday that, because of the bureaucratic hurdles involved, it’s a “common and frequent practice” for local healthcare professionals to help patients pay service fees to visiting doctors. He added that patients usually hand the fees to county hospital doctors, who then pass them along to the visiting experts.

“This (practice) helps address challenging cases at grassroots hospitals that lack skilled doctors,” said the county doctor, who asked not to be identified due to the sensitive nature of the issue.

Geng Xiangshun, an expert on public welfare issues, said that punishing Wang or Song — though the latter hasn’t faced any consequences for taking the money — would hurt patients in remote areas hoping for an expert consult. He added that hospitals must find ways to efficiently compensate doctors who travel to remote areas for work, and not make them pay for such trips out of their own pockets.

“This incident has destroyed not just one doctor, but many more patients waiting for adequate treatment,” he wrote on microblogging platform Weibo.

Though Han had paid the service fee to her doctor voluntarily, the 62-year-old patient shared her story online last month after finding out she needed further surgery. The local health authorities said Han wouldn’t be charged for her next procedure, and that they are still investigating the case.

Meanwhile, on Weibo, thousands of online users have rallied in support of the suspended doctor, and a related hashtag had been viewed over 270 million times by Sunday afternoon. “A doctor traveling great distances to treat patients should get paid and, though it remains a grey area, this practice benefits county-level hospitals,” wrote one Weibo user. “Doctors in remote areas learn while observing visiting experts. It also benefits patients, who would have to spend even more to travel to the capital for treatment.”

Editor: Bibek Bhandari.

(Header image: Shannon Fagan/XiXinXing/VCG)