Most of these observations are either completely or partially true. Corruption has many names, and one of civil society isn't innocent either.Professionals and businessmen of various sorts indulge in unscrupulous practices.I recently had a chat with some doctors, surgeons and owners of nursing homes about the tricks of their trade.Here is what they said.
1) 40-60% kickbacks for lab tests.
When a doctor (whether family doctor / general
physician, consultant or surgeon) prescribes tests
- pathology, radiology, X-rays, MRIs etc. - the
laboratory conducting those tests gives
commissions. In South and Central Mumbai --
40%. In the suburbs north of Bandra -- a whopping 60 per cent! He probably earns a lot
more in this way than
the consulting fees that you pay.
2) 30-40% for referring to consultants, specialists and surgeons.
When your friendly GP refers you to a specialist or surgeon, he gets
30-40%.
3) 30-40% of total hospital charges.
If the GP or consultant recommends hospitalization, he will
receive kickback from the private nursing home
as a percentage of all charges including ICU, bed,
nursing care, surgery.
4) Sink tests.
Some tests prescribed by doctors are not needed. They are there to inflate
bills and commissions. The pathology lab
understands what is unnecessary. These are
called 'sink tests' blood, urine, stool samples
collected will be thrown.
5) Admitting the patient to 'keep him under observation'.
People go to cardiologists feeling unwell and anxious. Most of them aren't really
having a heart attack, and cardiologists and
family doctors are well aware of this. They admit
such safe patients, put them on a saline drip with
mild sedation, and send them home after 3-4
days after charging them a fat amount for ICU, bed charges, visiting doctors fees.
6) ICU minus intensive care.
Nursing homes all over the suburbs are run by doctor couples or
as one-man-shows. In such places, nurses and
ward boys are 10th cl-ass drop-outs in ill-fitting
uniforms andre feet. These 'nurses' sit at the
reception counter, give injections and saline
drips, perform ECGs, apply dressings and change bandages, and assist in the operation theatre. At
night, they even sit outside the Intensive Care
Units; there is no resident doctor. In case of a
crisis, the doctor -- who usually lives in the same
building -- will turn up after 20 minutes, after this
nurse calls him. Such ICUs admit safe patients to fill up beds. Genuine patients who require
emergency care are sent elsewhere to hospitals
having a Resident Medical Officer (RMO) round-
the-clock.
7) Unnecessary caesarean surgeries and hysterectomies.
Many surgical procedures are done to keep the cash register ringing. Caesarean
deliveries and hysterectomy (removal of uterus)
are high on the list. While the woman with
labour -pains is screaming and panicking, the
obstetrician who gently suggests that caesarean
is best seems like an angel sent by God! Menopausal women experience bodily changes
that make them nervous and gullible. They can be
frightened by words like ' and 'fibroids' that are
in almost every normal woman's radiology
reports. When a gynaecologist gently suggests
womb removal 'as a precaution', most women and their husbands agree without a second's
thought.
8) Cosmetic surgery advertized through newspapers.
Liposuction and plastic surgery are not minor procedures. Some are life-threateningly
major. But advertisements make them appear as
easy as facials and waxing. The Indian medical
council
has strict rules against such misrepresentation.
But nobody is interested in taking action.
9) Indirect kickbacks from doctors to prestigious hospitals.
To be on the panel of a prestigious hospital, there is give-and-take
involved. The hospital expects the doctor to refer
many patients for hospital admission. If he fails to
send a certain number of patients, he is quietly
dumped. And so he likes to admit patients even
when there is no need.
10) 'Emergency surgery' on dead body.
If a surgeon hurriedly wheels your patient from the
Intensive Care Unit to the operation theatre,
refuses to let you go inside and see him, and
wants your signature on the consent form for
'an emergency
operation to save his life', it is likely that your patient is already dead. The 'emergency
operation' is for inflating the bill, if you agree for
it, the surgeon will come out 15 minutes later and
report that your patient died on the operation
table. And then, when you take delivery of the
dead body, you will pay OT charges, anaesthesiologist's charges, blah-blah- Doctors are humans too. You can't trust them
blindly.
Please Understand The Difference.
Young Surgeons And Old Ones.
The young ones who are setting up nursing home etc. have heavy loans to settle. To pay back the loan, they have to perform as many operations as possible.Also, to build a reputation, they have to perform a large number of operations and develop their
skills. So, at first, every case seems fit for cutting. But with age, experience and prosperity, many surgeons lose their taste for cutting, and stop recommending operations.
Physicians And Surgeons.
To a man with a hammer, every problem looks like a nail.Surgeons like to solve medical problems by cutting, just as physicians first seek solutions with drugs. So, if you take your medical problem to a surgeon first, the chances are that you will unnecessarily end up on the operation table. Instead, please go to an ordinary GP first.
