Friday, July 22, 2011

Why do doctors give kickbacks ? And what's the solution ?

It's very easy for people to moralise and wax eloquent about the declining standards of ethics and morality amongst doctors in India today. However, rather than blame individuals or the medical profession, I think we need to focus on finding a solution.

This is my viewpoint.

Individually, most doctors are good people. They enter medicine because they want to be of service to others - and most are intelligent, conscientious, idealistic and hardworking when they enter medical college.

However, as time goes by, they gradually become cynical and bitter. There are few positive role models they can look upto - and when they see their seniors indulge in unethical practises, they are quite resigned to toeing the party line. After all, how can you fight the "system" ? In India, isn't everyone corrupt, after all ? So why should doctors bother to live upto a different and higher standard ?

This clearly means the fault is not with the individuals , but with the system - and this is what we need to focus on.

I feel most doctors would much rather practise ethically and provide high quality medical care to their patients one on one - after all, this is what they have been trained to do, and they are good at this ! However, if there are no patients for them to see, they are going to use underhand means to ensure they do not end up starving !

This is why the new trend of providing corporate support to family physicians is so heartening. Companies such as PrimaClinic, HealthSping and Nationwide can focus on marketing, so they can ensure the doctor has a steady stream of patients to see . This will optimise the doctor's efficiency and throughput - and allow him to practise high quality medical care, without cutting corners or worrying about his daily income !

The competition for these companies is not each other ! India is a huge market - there's lots of scope for many players, and they can all learn from each other.The competition is the existing family physician and the entrenched nexus, which they will have to battle. The good news is that thanks to the internet, it's become much easier for these companies to reach out directly to patients, and explain to them the value they can add ( in terms of openness, service and transparency !) They can cut out the middleman !

Even better, these clinics will have to use EMRs and Information Therapy to educate and empower their patients, so the doctor-patient relationship will also improve over time !
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