Painful Truth Of Surgery

Apr 02 2015 : The Times of India (Delhi)

PAINFUL TRUTH - Hospitals drive docs to do avoidable surgeries to meet corporate targets

Ekatha Ann

The numbers speak of Chennai's rise as a medical capital: More than two lakh cataract surgeries in a year, a two-fold jump in caesarean section, a sharp spiral in hysterectomies. Statistics show doctors are becoming scalpel-happy. If your doctor asks you to undergo a cataract surgery , gall bladder or tonsils removal, or an operation of the lower back, please take a second opinion. Wide-ranging interviews with surgeons who testified before an NGO on corrupt practices in hospitals told TOI that often patients are forced to undergo unnecessary surgeries.  A senior orthopaedic surgeon in a corporate hospital explained the reason for this unsettling trend: “We have a quota to meet every month.Many of us see patients as a potential candidate on our operating table. Only two out of five, however, agree.Many go for a second opinion -and don't return.“ The surgeon is among 78 medical practitioners who gave testimony to a Pune-based NGO that compiled a report on unethical practices in healthcare. From Chennai, 12 doctors testified. SATHI coordinator Dr Abhay Shukla said elective surgeries (that do not involve a medical emergency) are the most popular. “Many of these surgeries don't involve too many risks, while at the same time fetch more rev enue for the hospitals,“ he said.  She was 33 years old when her uterus was removed. It never struck S Saritha to seek a second opinion when her doctor recommended a hysterectomy after scans revealed fibroids in the womb. “The doctor undertook tests and said surgery was the best option. I believed her,“ she said.  Three years on, Saritha quit her job as a software engineer as her body refused to keep pace with her work. It wasn't until much later she learned that her condition could have been treated with medication.  Saritha's story finds echo in a recent study by a Mumbai-based firm which revealed 44% of the 12,500 pa tients for whom surgery was recommended were advised against it by consultants who gave them a second opinion. Doctors say the practice of recommending surgery as the first resort is a growing problem in Chennai. Cataract surgery , knee replacement surgery , caesarean section, hysterectomy and operation on the lower back are the most popular ones among doctors.  Coordinator of NGO SATHI (Support for Advocacy and Training to Health Initiatives) Dr Abhay Shukla said elective surgeries, which don't involve too many risks, are the pre ferred way for hospitals to boost income. The NGO in February compiled a report on corrupt practices in healthcare. “A doctor said he was pulled up by the hospital administration for having only a 10%`conversion rate', the number of patients advised to undergo surgery ,“ said Dr Shukla.“To be fair, doctors are not entirely at fault. For a Rs2 lakh surgery , the doctor probably gets Rs25,000, while the rest goes to the hospital.“Most of the doctors TOI spoke to preferred to talk on condition of anonymity . “It is easier to practice independently . It gives you more freedom to serve your patients' interest. But, more people are drawn to the glamour attached to corporate hospitals,“ said a cardio-thoracic surgeon at a multispeciality hospital. He said doctors in his hospital are paid according to the number of procedures they undertake.  Former editor of Indian Journal of Medical Ethics Dr George Thomas said, “Any system that rewards a doctor for the number of procedures he does is liable to abuse“. “I usually recommend surgery for the elderly as they have a lot of other conditions like diabetes and hypertension that could aggravate their problem. We undertake procedures as a precautionary measure,“ said geriatrician Dr V S Natarajan.                http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=PAINFUL-TRUTH-Hospitals-drive-docs-to-do-avoidable-02042015011012#