10 ways in which doctors cheat patients

New Delhi, Sept 10 : A renowned physician Dr B M Hegde has shown how a large number of doctors working in five-star hospitals shortchange patients in order to keep their management happy and enrich their own pockets.

Here is what Dr B M Hegde writes:

"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.

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, 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, more  

View all 60 comments Below 60 comments
This is the result of forgetting the age old system of Family Doctors and going crazy over Corporate and 5 star Hospital culture. People are equally responsible for this state of affairs. Only when the day comes when citizens realize and reestablish their bond with the trusted family doctor, will such corruption come down; at least to a significant extent more  
I agree with Srinivasa Prasad. Through this group let us find an action plan. Can Dr Hegde help with full info. Like Even the Delhi govt came to know about high charges for Dengue test. more  
Why doctors are taken or considered because they are dealing such thing and job is extraordinary service to save the patients , all other categories are not taken as others civil servant /agents /government officials , their services are based on profit making and they multiply their greed as per requirements .
Important is becoming a doctor is devoted service and selfless behaviour because yr learning is apply in positive manner , not as businessman or money making machine .
But the sorry state , we are yet to understand the difference of humanity in life saving /or make a difference between greedy behaviour or Humbie as per need .
Again I intend to brief the content Nelima varma assessment for tricky way of earning money , keeping the humanity at door , Again the attitude of health authorities yet to be positive but it is not so, problem put by verma ji not as simple as we imagine , this requires a full thought full brainstorming by authority concerned to counter the social evil. more  
Any human feeling involved in the business is known as "adulteration" in the business !
What is business ? Invest finance in some affair and make more money out of that money and effort.There are hundreds of thousands of business where invest money and multiply your money .That is business .There are only business going on in this earth but nothing else Some take more profit and some less . All these profit are controlled by supply and demand .Even deposit money in the bank and getting interest is also come in profit make making (Depends up on the investment) Government taking part of it ,as sale tax ,excise duty ,income tax and so on .There are so many type of tax .Even revenue of this country depends up on these business .Every paid service is a business .Government doctors and government employees are paid by the tax paid by these business .They must give free service because they are paid to render service to the public by the tax payers money . Of course some of these doctors studies in government colleges by paying concessional fees .These fees considered to be less than what government spent from tax payers money .A concession have been given to doctors while they were studying .In that way there are aided school and colleges where all are studying except a few .That means ,not only the doctors but all have studied on concession and rest of the money have been spent from tax payers revenue. So not only the doctors but every one should render service to the public .Doctors have taken oath to practice their profession with ethics . But not free ! Government doctors and public servant should render service .Because they are paid by the government and it is for rendering service to the public.Why every body only so much disgusted with doctors .There are worst corruption is going on with our civil servant ? All doctors and private hospitals are doing business .They invest money and take profit out of it .No body is stopped from doing so. All people can choose to learn and do what ever they want .Of course we all can not get every thing what we want . Finally I would like to say one thing we all have to know what is business and who is supposed to render service except those kind hearted people who is always at your service .There are also many doctors render service with ethics .I am not a doctor and I am not supporting doctors .But we must know the fact instead of contempt more  
Dr.Hegde has been exposing business-oriented and therefore exploitation- oriented practices in the fields of drug-making, drug-certification, random large scale tests on population on the usefulness of drugs, analytical tests, prescriptions, diagnosis procedures etc. I have been reading Dr.Hegde's articles in Bharatiya Vidhya Bhavan's journal...... I have been wondering is it not the correct juncture for Dr.Hegde and other humane -philanthropic medical/surgical professionals, voluntary organizations to join as a GROUP to bring about drastic reforms by attracting the attention of the highest courts, parliament and other avenues best known to them?. I have been observing all sorts of people, rich and poor, innocent and clever , marginally ill and severely ill,are getting the worse from the medical and pharma sectors, in a majority of cases. Only a few Doctors are treating patients with minimum tests/minimum drugs/minimum recovery time. more  
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