Friday, June 05, 2009

Should doctors pay for patient referrals ?

Reproductive tourism has become very popular, and lots of patients now travel to India for IVF treatment. This is a very competitive field, and there are many IVF clinics in India today.

In order to facilitate travel for patients who come from other countries to India, many medical tourism companies have been established. They help patients to identify a good clinic and assist them with their paperwork and travel. This is a useful service, as it helps patients who are not comfortable with travelling to India with a lot of peace of mind, as they have a "local person" they can talk to.

Many of these companies approach us, and expect to be paid a commission for referring patients to us. This is not something I am comfortable doing, so we have refused to do so. While I am quite happy with their charging patients for the services they provide to them, I am not comfortable about their lack of transparency ; and that patients are not aware that these companies are taking a portion of the medical fees. Isn't this simliar to giving a cut or kickback ?

However, this means we are losing patients to competing IVF clinics who are happy to pay these commissions. Are we being stupid ? Is there anything wrong in giving these companies a
" service fee " or "facilitator fee" ?


  1. Hi Dr. Malpani,

    I guess one way of looking at it is Customer Acquisition Cost, very similar to the advertising cost/cost of listing your service in a YellowPages etc. If the medical tourism companies are charging doctors for pushing their service to the customer (without a clear communication to the patient), then I would consider it unethical.
    Don't Doctors get such kickbacks (in cash or kind) from the nearby chemists, pharma companies and the pathology labs. If doctors are fine with that, then they should be fine with this as well. Don't you think so ?

  2. Not all doctors take kickbacks ! If they did, then there would no problems at all.

    Kickbacks - no matter what you disguise them as - are still just that. I guess doctors could consider this to be " the cost of doing business" - but then we will stop treating patients as patients, and start treating them as customers !


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