Majority say a corrupt nexus exists between many pathology labs and doctors
- • 91% say path labs should lose licence if found incentivising doctors for referrals
- • 86% say doctor’s earnings in a hospital should be unrelated to the number of tests they refer to the hospital’s pathology/diagnostic lab
November 22, 2017, New Delhi: One of the important cogs in the wheel of the medical system in our country are the pathology labs. Being a high profit business, thousands of them have mushroomed in different parts of the country. Many people say that these pathology labs have a tie up with the doctors and pass on a commission to the doctors for every patient they send to them. To check the citizen perception on this issue, LocalCircles conducted a detailed survey, which received more than 43,000 responses from over 29,000 citizens across the country.
The first poll asked how many time they felt that their doctor ordered more tests than were actually required. 36% said it happened 1-3 times, 23% said it had happened more than 3 times, 25% said it had never happened and 16% did not know.
It is believed that as an industry practice, up to 30% of the cost of the pathology tests go to the doctors, which motivates the doctors to prescribe unnecessary tests to the patients. This ‘motivation’ is also provided in form of gifts, sponsored holidays etc.
The second poll asked if doctors had suggested them to use a particular pathology lab for tests to which 47% replied saying most of them have, while 27% said only some of them have. 17% said none of them suggested a specific lab and 9% were unsure about it.
The third poll asked if pathology labs should lose their license if found to be incentivizing doctors to prescribe medical tests. 91% agreed with it while only 5% did not agree with it. 4% were unsure about it.
86% also agreed to putting a mechanism in place where for a doctor associated with a hospital, their earnings & incentives are completely unrelated to the value of tests they refer to the hospital pathology labs. Only 11% disagreed with it and 3% did not have an opinion on it.
Some instances have been reported by citizens where the hospitals give a ‘pathology or diagnostic lab’ target to doctors working with them and decides their remuneration based on it. This pushes the doctors further to prescribe unnecessary tests to the patients.
The next poll asked citizens how many cases have they had in the last 3 years where the pathology reports they had received were wrong. 26% said it had happened up to 3 times and 6% said it had happened over 3 times. 43% said it had never happened and 25% said they were not sure about it.
It is also not very uncommon to receive wrong reports from pathology labs. Due to lack of proper guidelines, enforcement and greed to earn more money, some of these labs flout rules and play with health of patients, according to the citizens.
The last poll asked citizens how much they trust the pathology lab that they use for getting medical tests done. 34% said they had low level of trust and therefore they stay vigilant, 37% said they had high level of trust but still stay vigilant, 20% said they fully trust them and 9% said they had very low level of trust.
According to some of the members, ‘Sink tests’ are also a common occurrence where tests are prescribed just for the sake of it and the samples are just thrown in the sink and patients are given pre-prepared standard reports saying all is well.
In various structured discussions, citizens also suggested that a Government agency should be constituted to keep a check on the private medical labs and diagnostic centers. Some other suggestions included rating labs on set parameters, making it illegal for labs to pay commission to doctors for referrals, severely penalizing errors in reports and government prescribing a maximum price for each kind of test.