Thursday, September 22, 2011

How Indian Doctors Loot Patients.

There's this email which is doing the rounds in India today.

" It is by Dr. B M Hegde.

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 & 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 class drop-outs in ill-fitting uniforms and bare 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

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

Prof. B. M. Hegde,
Padma Bhushan Awardee 2010 "


Here are my comments.

Sadly, there is a grain of truth in this, but fortunately, most doctors are NOT like this !

This kind of doctor-bashing just makes a bad situation worse, in my opinion, because it destroys the trust between doctor and patient.

We need to provide constructive win-win solutions !

Information Therapy – the right information at the right time for the right person – can be powerful medicine ! Ideally, every clinic , hospital, pharmacy and diagnostic center should have a patient education resource center, where people can find information on their health problem .

If patients are well-informed, they'll be able to differentiate between good doctors and bad doctors much more effectively !

HELP will be organizing its 2nd Annual Conference on Putting Patients First. The theme this time is : Using Information Therapy to Put Patients First in India.
The website is at

This will be held at Nehru Centre on Sunday, 9th October’11 . Mr.Ken Long , Vice President, International Operations at Healthwise, U.S.A, will be the keynote speaker and he will be talking on “What Healthwise is doing in the US to Promote Information Therapy – what we’ve learned so far”.

On this occasion, we will be releasing a book titled, Using Information Therapy to Put Patients First.

If you are worried about the quality of medical care your doctor provides you, and want to know what you can do about this, please do accept this invitation – I promise you it will be worthwhile !

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  1. Dr. Hegde himself has denied in his own website having written any such article. Please read

  2. This is doctor bashing at its best
    definetly not what the doctor shud order

    there cud be lot of examples but not all can be painted in same brush
    we r a couple dr and when in India had our family clinic for more than 2
    we never got any comission we used to give free treatment for all disabled individuals
    we used to give free samples too
    pl desist from such generalisation
    if there are some nay even many blacksheep today think it is a representation of todays society
    how can u xpct one profession alone to escape this

  3. Anonymous6:41 PM

    Based on the fact that Dr. Hegde has denied writing this article and that you support information (true information, I assume) therapy - I request you to take this article out or put a note right on top of the article in bold letters that this is not written by Dr. Hegde.

  4. Des it matter who has written the article ? Either its content is true or false - and that's what we should be focusing on !

  5. why ethical values are only expected from doctors who spent cores of rupees and decades of their precious lives for the benefits of community....i totally agree that doctors should not loot patients but growing tertiary care hospital network and horrible compition makes them to live in symbiotic relationship ...if not refered timely patients may get conplicated...sound referal is key of healthcare..if patients quality of healthcare is not hamperd then i don't think any problem in referel practise system in india....every business grows with strong interaction of its team members.....its upto the patients weather to go higher or next gp...nobody forces can not blame this noble proffession by just few unethical practitioners.

  6. Patients object to the lack of transparency. Taking money under the table increases their costs; and also affects their quality of medical care, because the GP may refer them to a specialist who is not competent, for personal financial gains

  7. Anonymous1:51 PM

    Doctors nowdays have no ethics feeling of how patient is suffring from mentally and physically.i have seen a lot of such examples. Even one peny they can't take with them after the end of life. u reap what u sow


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