Is there a sinister campaign against Indian Healthcare

Recently we have seen front page reports in leading newspapers like Times of India about the malpractices of doctor commission in referring patients for diagnostic tests or to higher hospitals. Read in indepth story from Kuldeep Chaudhary

A couple of months back British Medical Journal ( BMJ ) came up with a story about corruption in Indian Healthcare. It was mainly focused on the Kick Backs that the doctors receive when they refer patients either for some diagnostic tests or to a higher hospital for some specialized procedures.

The practice of `Fee sharing' or `Referrals' is neither new nor exclusive to India. Every country on earth has same kind of system but by different names. In more developed countries it is called `Group Practice' and instead of cash the matter is dealt in terms of holidays, golf games, club memberships etc.

So why target India and specially at a time when Medical Tourism in India is threatening the business interests of developed countries like UK, Germany and USA. Is this an attempt to malign the Indian Healthcare and thereby sow a seed of suspicion in the minds of the potential patients who are willing to travel to India in search of good quality treatment at very low cost. Has our low cost of treatment become an eyesore for the medical professionals in the developed countries. The timing and the relevance of such articles definitely point in this direction. There are a thousand problems in Indian Healthcare but pointing out towards a non-issue suggests that there is something amiss.

I have been in Indian Healthcare for the last 15 years and have worked at Diagnostic Centres and Tertiary Care Hospitals. I can vouch that the referral practice for almost 90% of the doctors is based on `Keeping the best interests of the patient in mind'. When a doctor would get same amount of incentive from virtually every institution then why would the doctor not keep the interests of the patient supreme. The practice of any medical professional is based on best treatment outcomes and since almost every doctor earns more than 90% of their total income from their practice, it is foolish to believe that anybody would be misguiding their own patients. 

It is a fact that not every kind of treatment is available with every medical facility and they have to refer patients outside either for some specialized diagnostic tests or to a higher centre for some specialized treatment. Since the continuity of treatment is the responsibility of the referring doctor, fee sharing has nothing unethical about it. At the same time, there are some medical professionals, mostly quacks who would refer a patient purely for monetary gains but their number is miniscule. There are some hospitals or nursing homes who indulge in the practice of overcharging a patient so that they can pay a higher referral fee but they do not constitute even 10% of the Indian Healthcare. 

There is too much hullaboo against unnecessary investigations, but in the absence of any established guidelines the doctor has no choice but to get the patient properly investigated as any lapse in this regard can be claimed by the patient as `medical negligence'. 

The hospital marketing teams in all the developed countries tie-up with medical tourism companies and share the revenues from the patients which get referred to their hospital and find nothing wrong in the practice. This kind of report therefore seems nothing but an attempt to tarnish the image of Indian Healthcare. Indian media which is currently without any news is also lapping up to such stories and giving them prime space. 

On the occasion of the Doctor's Day, I would like to give my best wishes to all the great Indian doctors who perform their duty in difficult circumstances keeping the interests of the patients supreme in their mind and actions. Whatever is wrong with Indian Healthcare can be easily dealt by us and we need no lecturing from British Medical Journal on the same.


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