Saturday, August 13, 2016

The kidney transplant racket

The kidney transplant case at Hiranandani hospital has grabbed all the headlines , and the media is now having a field day at the doctor's expense.  If you are getting a sense of deja vu, this is because this story has a predictable course. In order to understand why this happens repeatedly, we need to look at some background.

 In order to prevent racketeering in kidney donation, , the government passed a  law. This was done with the best of intentions, but it's not in a position to implement it, because the law is crafted by people sitting in ivory towers, and has no connection with ground reality.

The rules  look great on paper, but are onerous and difficult to comply with. Law-abiding hospitals and doctors try to do their best to conform to them, in order to improve the quality of life with patients with kidney failure to lead a better life.  Doctors start doing these procedures routinely , and most of them go off smoothly, so that everyone is happy.

However, when problems with one patient surfaces, everyone whips themselves up into a state of righteous indignation. They then go through all the clauses in the Act with a fine-tooth comb, and point out one or two rules which were breached, usually inadvertently.

Because of the way the Act has been drafted, I can pretty much guarantee that you will be able to find this is true of practically each and every transplant carried out in the country. The rules are  impossible to comply with, because they were laid down by people who have no idea what happens in real life. They are safely ensconced in their ivory towers , and don't have any understanding about the living hell which the patient with kidney failure goes through.

Doctors, on the other hand, want to do their best to help their patients lead a better quality of life, and they go out of their way to help them. Then , when a complaint surfaces, it the same doctors who are taken to task. It's very easy to make doctors the scapegoats, because they're the ones who actually do the procedures.  What's heartbreaking is how readily everyone is willing to assume the worst about these doctors - that they are crooked , and are the scheming masterminds who have plotted a con in order to get rich at the donor's expense.

The reality is that the protection which is supposed to be provided to the donor by a government authorized committee is what was at fault in this case. Interestingly, the government official on the committee , who is supposed to be an objective third party, is nowhere to be found. Even worse, the conmen who actually organized the scam are missing because they were let out on bail ! The police have very conveniently locked up the only people who are easily available - the doctors, who are usually innocent victims. They have successfully managed to ruin  the doctor's reputation , as well as the hospitals.

What people fail to realize is the amount of damage this is going to cause to other kidney failure patients. Every doctor is now going to say "Why should I stick my neck out? It's the kidney patient's problem, not mine."  Most sensible doctors will just stop doing kidney transplants - after all, why risk a jail sentence in order to help a patient ? There are lots of other operations they can do ! Also, the compliance paperwork which would earlier take a month will now end up taking a year, because no hospital will want to take a chance that they have breached a rule. They will make sure that every i has been dotted and every t has been crossed, in order to protect themselves. The government is great at creating lots of red tape, and they will generate lots more, in order to prevent a similar incident from recurring.

A huge problem is that doctors fail to stand up for each other. The poor doctors who have been locked up in jail are too scared to talk . They don't have a voice, and their family members are also scared . Sadly, their patients will not support them, and the press is very good at distorting the story . They will highlight the 1 or 2 deficiencies and discrepancies, without pointing out that of the 100 rules which have been laid down, 99 have been complied with properly, which clearly goes to show that there was no intent to commit fraud , as far as the doctors were concerned.

I honestly don't understand how it is in the doctor's best interest to commit a fraud, because they get paid for doing the surgical procedure .  The middleman who forges papers in order to con the kidney donor who is the one who should be taken to task, along with the government official whose job it is to verify all the documents.

The government should accept responsibility that they have failed all the patients with kidney failure. They have created laws which are impossible to implement, and then when they find that the laws are broken, rather than punish the person who's broken the laws, they end up punishing the doctors who are soft targets.

This episode has crushed the morale of many doctors , who're already quite fed up and frustrated. Unfortunately , they don't have a united voice and they continue to be the favourite whipping boys for the press, because they are soft and helpless targets.

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