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Dr.B.M. Hegde has written two books and it is a must for every one to read.
'What doctors do not study in Medical colleges'
Now he is bold to reveal all these.
This is from Dr. B M Hegde. Wonder how much is widespread and how many are merely a few black sheep.
How Indian Doctors Loot Patients.
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 & 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 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 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 councilhas 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.
11) 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.
12) 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, MD, FRCP, FRCPE, FRCPG, FRCPI, FACC, FAMS. Padma Bhushan Awardee 2010.Editor-in-Chief, The Journal of the Science of Healing Outcomes,Chairman, State Health Society's Expert Committee, Govt. of Bihar, Patna.Former Prof. Cardiology, The Middlesex Hospital Medical School, University of London, Affiliate Prof. of Human Health, Northern Colorado University, Retd. Vice Chancellor, Manipal University, "Manjunath"Pais Hills, Bejai. MANGALORE-575004. India.
https://www.facebook.com/chandrasekhar.narayanan.9/posts/804866019582974
This Indian doctor's study reveals how far virus of commercialisation has spread in the healthcare sector-By Monalisa Das | March 6, 2015 |
A leading cardiologist in a corporate hospital in an Indian city was approached by a junior specialist with a problem he didn't seem to have an answer to.
Each day, the hospital sees around 100 people in the OPD (Cardiology). 10-15 of them are usually referred for a procedure, like an angioplasty. The process of referring patients for procedures is also known as conversion rate.
The management of the hospital had asked the junior specialist to increase the conversion rate to 40 percent and if he failed to do so, he would be shown the door.
"What could I tell him (the junior specialist)?", asked the senior doctor, who was unaffected by the management pressure since he was an established doctor and also ran his private practice.
This is just one of the several conversations that Dr Arun Gadre, a former gynecologist and now a health activist, had with doctors from across the country while researching for his project.
Dr Gadre, who worked as a gynecologist for two decades in a district in Maharashtra, conducted interviews with 78 doctors in India in 2014 in an effort to find out about malpractice in India’s private healthcare sector. The British Medical Journal (BMJ) published parts of the study and its findings late last month.
The three common malpractices in the sector, as found in Dr Gadre's paper, are kickbacks for referrals, irrational drug prescribing, and unnecessary interventions. The private healthcare system largely treats patients as revenue generators, without rationality or medical logic, Dr Gadre writes in his study.
In Maharashtra,a general practitioner said that doctors get Rs 30,000- Rs 40,000 (£300-400; €450-550; $500-650) for referring patients for angioplasty. A pathologist said that of 150 doctors contacted only three were willing to refer patients for investigations without kickbacks.
Speaking to The News Minute, Dr Gadre says that over the last two decades, the virus of commercialisation has spread across the health care sector in the country and has reached suffocating proportions.
"A certain patient is sent 60 km away for a test because a doctor sitting in the city is getting commission for it. We are not treating patients as human beings. It is disgusting", says Dr Gadre, adding that 'the root of the problem is commodification of medical care'.
The study published in the BMJ states that though many doctors in Maharashtra are trained in homeopathy and ayurveda, they practise allopathic medicine using cursory knowledge imparted by drug company representatives.
A little girl was given corticosteroids by a homeopath for red eyes, and long term use led to a cataract that required surgery.
Of the several doctors interviewed, many mentioned unnecessary investigations and surgical procedures. 'One example was gynaecologists performing sonography without indications in pregnant women who complain of trivial pain in their abdomens, then fabricating false reports of cervical abnormalities and advising the women to have cervical stitches, with the pretext of preventing miscarriage. Few patients request a second opinion, and the doctor does not give them any documents to avoid being found out', says the study.
The malpractices across the health care sector is much more common today than when Dr Gadre had begun his practice, he says. "Today, there is stiff competition amongst doctors and other medical specialists too, especially for a new comer. A new comer must have spend around Rs 30 lakh on his studies. To set up his own practice, he will need a huge investment and so might resort to malpractices to earn commission", he explains.
Take the example of the "sink test" as explained by a pathologist to Dr Gadre. 'The referring doctor advises a battery of laboratory tests despite no suspicion of pathology. Only a few of the tests are performed, and the extra blood collected is dumped in the sink. Fabricated results are given in the normal range for all tests that were not performed. The patient pays a large sum, which is shared by the referring doctor and the pathologist', states the paper.
A physician also mentioned that pathologists pleased referring doctors by giving false reports, such as labelling healthy patients as having diabetes so that they are dependent on the referring doctor for life.
When asked if doctors often succumb to pressure of their orgnaisations, Dr Gadre says, no one can pressurise an individual to act against their wishes, and this applies more to referral doctors. "Some of them depend on commission for their survival", he says.
However, Dr Gadre feels that one cannot generalise in such a situation. "There is a section of doctors, a small one, and they are fighting against the commercialisation of the health sector. There are good hospitals too", he says.
What needs to change is the attitude with which the sector at present is run. Dr Gadre states that "it functions as an industry where commodities are brought and sold and the only motive seems to be generating profit."
Amidst the concerns surrounding the deterioration of rationality and ethics in India's health care sector, the roles of medical specialists also seems to be affected.
A universal health care system can perhaps be a solution to the problem, Dr Gadre feels. "Several countries across the world, including UK, Canada, Europe and Thailand have accepted this system. Then why can't India?", he asks, adding "We are moving towards the Public Private Partnership (PPP) model, but there is no accountability in the sector, which is scary".
"The Medical Council of India (MCI) is not so visible in implementing guidelines. It can definitely control the problems if it takes a pro-active role", Dr Gadre concludes.
All the interviews by Dr Gadre will be compiled into a book and published by Penguin later this year.http://www.thenewsminute.com/lives/830
Let’s Fight Against Medical Mafia of Unscrupulous Doctors, Hospitals, Pharmaceutical Companies and Diagnostic Labs
The menace of medical mafia of unscrupulous doctors, hospitals, pharmaceutical companies, diagnostic laboratories etc has been increasing day by day in our country. The medical profession which used to be considered as a very noble profession has earned notoriety because of malpractices by unscrupulous doctors, hospitals, pharmaceutical companies and diagnostic laboratories.
The common malpractices
1. Some doctors prescribe unnecessary and expensive medicines manufactured and marketed by those pharmaceutical companies who pay commission to those doctors..2. Some doctors, nursing homes, hospitals etc force patients psychologically for surgical operations for making their high bills while that may not be required. For example, now-a-days some doctors opt for caesarian birth of babies instead of natural delivery
3. Some doctors prescribe for unnecessary pathological tests just to get commissions from pathological laboratories. It has been heard that some hospitals pay Rs 30,000 to Rs 50,000 to doctors for referring a patient for angioplasty
4. Some hospitals prolong the medical treatments and stay of patients in their hospital just for the sake of increasing their bills
5. There have been unethical nexus between doctors and foreign pharmaceutical and Medical Research companies who try new drugs on poor patients in India without their knowledge
6. Some doctors and hospitals have been engaged in illegal human organs trading.
7. India has become a hub of surrogate mothers who rent their uterus. Some doctors and hospitals who are engaged in this unscrupulous business have been treating babies as products just to serve their monetary greed.
8. Some pharmaceutical companies and hospitals have been causing fears and myth through their publicity campaign just to sell their un-required products.
There may be so many other malpractices too. These medical professionals have been so blind for money that they hardly respect human lives. For them, patients are just products. If these things bother you, then, you are requested to join our hands in initiating a campaign against this unscrupulous medical mafia.
Thanks,
Swami Aaron
http://ultimatebliss.in/let_us_flight.php
Unnecessary surgeries, jacked up bills: Docs reveal all
New Delhi: March 6, 2015, DHNS:
The narrative they recounted range from unnecessary angioplasty that fetches a commission of Rs 30,000-40,000 for a doctor to fake cataract surgery, needless pathological tests and jacking up the chemotherapy bills from Rs 25,000 to Rs 65,000, taking advantage of the helplessness of a cancer patient.
A pathologist said that of the 150 doctors he contacted only 3-4 were willing to refer patients for investigations without kickbacks. “I am able to manage only because I have other sources of livelihood,” he said.
The 78 doctors interviewed in the report are from Bangalore, Chennai, Delhi, Kolkata, Mumbai, Nashik, Pune and other smaller towns. As many as 53 have more than 30 years of experience while 16 of them spent 20-30 years in the medical profession. Only two have less than 10 years of experience.
“Sometimes we tell our patients that cancer has spread extensively and hence an operation is not possible. There is no further cure that can be attempted. Then the patient goes to a private facility. There they do some smooth talking, play on the emotions of the family and perform an operation, which is certain to fail – and thus make a lot of money,” L R Murmu, professor of surgery at the All India Institute of Medical Sciences was quoted in the report.
Last week, an abridged English version of the report – originally written in Marathi – was released. A detailed version is expected in October. One of the authors wrote an article in the British Medical Journal and received both bouquet and brickbats on the methods and findings.
“My methodology may not be correct but I don’t believe a random sampling method would have resulted in any different outcome. Fifty three doctors have more than 30 years of experience. They have nothing to fear,” lead author Arun Gadre, who practised gynaecology for two decades in Lasalgaon in western Maharashtra told Deccan Herald.
The report comes in the wake of the Central government’s new draft health policy where additional emphasis has been given on private medical sector for providing healthcare. The Clinical Establishment Act, 2010, for regulating the private healthcare sector, has found few takers among the states.
Paying money does not guarantee good healthcare as the private healthcare system largely treats patients as revenue generators, without rationality or medical logic, says the report titled “Voices of Conscience from the Medical Profession.”
Anti-corruption watchdog Transparency International claimed that the Indian healthcare sector is the second most corrupt organisation that an ordinary citizen has to encounter and only next to the police force.
http://www.deccanherald.com/content/463926/unnecessary-surgeries-jacked-up-bills.html
Your doctor gets 40- 60% kickbacks from pathology labs & other referrals!!
Corruption has many names, and one of these names is “commission”. The government is no doubt corrupt… but 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 told me:
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 paid him!
2) When your friendly GP refers you to a specialist or surgeon, he gets 30-40% from them.
3) 330-40% for referring to consultants, specialists & surgeons.0-40% 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 etc.
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 into the sink.
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 etc.
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 caesarian surgeries and hysterectomies. Many surgical procedures are done to keep the cash register ringing. Caesarian 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 caesarian 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“cysts” 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 delay.
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-blah.
Doctors are human too. You can’t trust them blindly. Please understand the difference between:
• 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 surgery.
• 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.
Warm Regards,
Krish
98215 88114http://blogs.rediff.com/backfoot/2011/02/17/doctor-commissions-kickbacks-pathology-labs-hospitals-specialistsreferrals/
Doctors, diagnostic cartels fleecing patients: Harsh Vardhan-Times of India-23.07.2014
Dipak Kumar Amit Dash
NEW DELHI: Expressing concern over a likely "cartelization" among diagnostic centres and pathological laboratories in Delhi, health minister Harsh Vardhan on Tuesday told Lok Sabha that patients are subjected to unnecessary tests by the doctors who are guided by the "lucre of commissions" offered by diagnostic centres.
He also said the government is considering to bring some type of oversight for pathological laboratories and diagnostic centres to end the corrupt practices including possible nexus between doctors and the laboratories, and cartelization among diagnostic centres.
Vardhan was laying a statement in the House on a sting operation by a private TV channel, which exposed some doctors collecting 30-50% commissions on magnetic resonance imaging (MRI), CT Scans, ultra sound, routine pathological tests.
"A kind of cartelization has resulted in so far as this aspect of the medical economy of Delhi is concerned. All the private laboratories and diagnostic centres charge roughly the same amounts for pathological tests and clinical examinations. Patients have no option but to pay up the exorbitant fees...This exacerbates their physical and mental agony," he said.
On the likely doctor and diagnostic centre nexus, the minister said that the "racket" is leading to unjustified profit margins. "This is apparent from the rate of commissions paid. In quite a few parts of the sting operation, the staff of the diagnostic centres reveal that they pay referring doctors as much as 50% commission on expensive tests like MRI. This indicates that even after paying the huge rate of commission these clinics report good profits," Vardhan said.
Stating that accepting commissions is a violation of code of ethics, the minister said he has written to the president of Medical Council of India (MCI) to call an emergency meeting of its ethics committee and post the minutes of the meeting on its website.
The minister also said "nefarious" practices are thriving in the medical sector and patients need to be protected from them. "The laissez faire spirit that dominates this business in India works to the disadvantage of the consumer and needs correction," he said.
Underlining the need to codify laws relating to clinical/ diagnostic examinations, Vardhan said his ministry is drawing up a panel of reputed medical practitioners and consumer law experts to suggest measures for introducing greater transparency and accountability in medical practices.
Earlier in the day, the minister assured Rajya Sabha members that the government would soon address the issue of rising cost of healthcare. Raising the issue during Zero Hour, Congress MP Shantaram Naik said hospitals should not be allowed to trade in medical devices and charge high prices for these from patients.
"Patients were being forced to pay double or even triple the price for medical devices at hospitals. As most of these are not available in the open market, patients can't check prices and are held hostage by hospitals, which force them to buy at the price they quote," Naik said. He added the government should make it mandatory for hospitals to declare the maximum retail price on each device could help cap the price.
http://timesofindia.indiatimes.com/india/Doctors-diagnostic-cartels-fleecing-patients-Harsh-Vardhan/articleshow/38888075.cms
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