By Biswaraj Patnaik, August 31, 2015 : After battling for thirteen long years, a doctor couple won over Indraprashta Apollo Hospital for medical negligence that had resulted in the birth of a mentally retarded and physically disabled baby.

The National Disputes Redressal Commission [NCDRC], holding the attending doctor Sohini Verma and Indraprashta Apollo Hospital guilty, directed them to cough out one crores of rupees in compensation to the couple. Incidentally, the disabled child too was called back by God after living painfully for 12 years.

The NCDRC had found badly tampered original medical records with signs of cutting and erasing to hide the documented dosage of a dangerously sensitive drug called Syntocinon which causes irreparable damage to the foetus. Doctors’ lust for money destroyed a family.

The corporate hospitals boast of much superior quality of healthcare than that of state-run outfits to justify astronomical sums of money in service charges.
But it has been indisputably proven that greed-driven guile in the Medical industry stems from ‘profit lust’ of hospital promoters and administrators who are no better than heartless, blood-sucking traders. No wonder, most doctors in India perform meaningless surgery and other procedures just to meet their corporate targets and make illegal money from kickbacks.

Eminent ethical doctors across the country feel terribly upset that the doctors, long known as saviours, play a key role in promoting ‘kickbacks and bribes’ that oil every part of the healthcare machinery.
Corruption in Indian medical practice was boldly highlighted by Dr Samiran Nundy, a leading gastroenterologist, in a fearlessly candid article published in the British Medical Journal wherein he says that bribe and kickbacks in healthcare delivery is all pervasive- starting with capitation fees for entry into private medical colleges the chief source of ‘doctor harvest’ on Mnday.

Dr Nundy’s article “Corruption in Indian Medicine”got published just as the Kokilaben Dhirubai Ambani Hospital in Mumbai was forced to admit, in a letter to the Maharashtra Medical Council, that it offered “incentives to doctors” for referring patients for admission. A complaint filed before the MMC had stated that the big Ambani hospital had been enticing doctors for enrolling in a forum with the promise of an annual reward of 1 lakh rupees for 40 admissions, 1.5 for 50 and 2.5 for 75. Dr Nundy’s article was inspired by an Australian medico, Dr David Berger who had served as a volunteer in a small charitable hospital in the Himalayan region. He lucidly describes how reference for an electrocardiogram (ECG) at private heart clinics or other investigations entitle a 10-15% kickback to the referring doctor. Dr Berger had witnessed a patient, with no apparent structural heart disease and uncomplicated essential hypertension, being recommended by a cardiologist to go for echocardiogram once every three months only for kickbacks.

In many of our five-star corporate hospitals, the main motive is to make easy profit and please the shareholders. So, an institutionalized system of so called ‘facilitation charges’ or fees for ‘diagnostic help’ is put in place for expensive procedures including organ transplants.

Not surprisingly, corporate hospital doctors are routinely confronted by the in-house financial officers to justify their salaries without generating adequate revenue for the hospital from investigations and surgical interventions. The “temptation” to subject patients to unnecessary CT scans, MRI, procedures like caesarean sections and hysterectomies is irresistible only to steal money without being caught.

Dr MK Mani, chief nephrologist at Apollo Hospital Chennai, says that the practice of doctors getting kickbacks from is now done openly. In rare cases of ethical doctors refusing to take such ‘cuts’, a little part of the stolen money is given away to the patients by way of discounts.
Several complaints with proof have been filed with the Medical Council which hardly takes any action because officials there too have been corrupted.
Dr Mani has formally cautioned the Medical Council that practising doctors should be punished instantly if ever found indulging in ‘fee splitting’ as that amounts to gross violation of the guidelines. It also causes great financial distress to poor patients.

Dr Sanjay Nagral, a famous surgical gastroenterologist, is a member of the editorial board of Indian Journal of Medical Ethics. He believes that the widespread practice of ‘cuts’ is linked to the way the increasingly dominating private sector in India, is vying for the market. In case of nationalized healthcare, as in the UK, doctors are paid a full time salary. So there is no scope of any incentive for them to recommend unnecessary procedures or investigations. Reversing such indiscriminate privatization as is happening in India, would only be possible if there is a strong political will. The best result would occur if there is a public outcry to influence policy makers by scaring them with dire political consequences. Then only a few ‘Kickback doctors’ can be tossed into jails and fear would play as a key deterrent for the greedy guys in the healthcare industry.

Greed is the chief driving force for hospital owners cutting corners in medical systems and training.

The contagious countrywide system of kickbacks in the medical industry now counts for 25%-30% in cuts and commissions from drug distributors-manufacturers, and another 25% for diagnostic and hospital admission referrals. For all this, the doctors have mastered the art of cross-referring to other doctors in their ‘kickback circle’. This inevitably leads to poor patients dying before actual treatment begins or rendering their families permanently impoverished. Similarly 30% kickbacks comes from surgical equipment manufacturers through dealers. Imported drug-elluting stents costing Rs 40,000 are sold for Rs 1.2 lakh at private hospitals.

The alarmingly rising number of Caesarean sections forced on pregnant women proves that ‘natural delivery’ in private hospitals of India is a rarest of rare phenomenon. And there is the kidney transplant racket for clients in the United States, the United Kingdom, Canada, Saudi Arabia and Greece.
A right to information request filed by an Oxfam-supported local NGO in the Dausa district of Rajasthan showed that 258 of 285 women investigated over a six month period were tricked to undergo unnecessary hysterectomies, most of them were under 30, the youngest being only 18 years old. According to Oxfam’s global spokesperson Araddhya Mehtta, very poor women with ordinary abdomen pain have been advised cut-linked hysterectomy by doctors who scare patients with possibility of cancer or a hole or a stone in the uterus without putting them thorough investigations.

In 2013, it was found that the largest chunk of practicing doctors in the country do not hold even the minimum MBBS degree to prescribe modern medicine. Lack of patient protection laws and abundance of corrupt government authorities everywhere have resulted in ever increasing robbery by doctors and officials as there is no mechanism in place to nab them for the severe crime.
One Dr Pradeep Jain’s gross negligence nearly killed an elderly woman. Jain carelessly administered penicillin to which the lady was severly allergic.

When the worst happened, Dr Jain kept conducting unnecessary surgery to cover up his unforgivable mistake. Even after all that, Jain told the patient’s son to urgently buy a non FDA-approved Japanese pill which could save mom’s life, only because he could get a fat kickback. The number of such ‘doctor robbers’ is growing by the day. It is said that in India, if the diagnosis indicates anything more serious than a simple fever or cough, seeking a second opinion only may protect one from daylight robbery.

So, the patient or family members or friends have to do a thorough research on hospitals and doctors before taking a final decision even if the case be cancer.
Commissions and cuts in the healthcare domain are illegal in most of the developed countries.
The government doctors in India too are equally devilish as they grab the public-funded salary and work for unethical private hospitals to make big kills by fearlessly shirking duty.

Interestingly, half of the doctors treating people at private hospitals are not even medicos. The bigger the imposter, the whiter the appron and more vulgar is the display of the lengthier-than-usual stethoscope hanging at the neck. Further, most of the younger doctors may have entered into medical colleges by cheating at the tests or passed final exams by bribing. Needless to mention that private colleges accept the wealthy first no matter if the student is congenitally a moron.

Recently, there was news of two candidates scanning the question paper at an All India Post Graduate Medical Entrance Examination conducted by AIIMS, by using mobile phones strapped to the wrist, concealed under their shirt sleeves. The images were then transmitted to a control room and downloaded. The paper was solved, and the answers dictated to the candidates with tiny bluetooth devices stitched near the collar to avoid detection. So the future is going to be extremely dangerous as quarter-baked doctors will be prowling the hospitals all over the country to drastically bring down the population by committing mass homicide unwittingly.

According to Oxfam’s global spokesperson Araddhya Mehtta the majority of poor women in India have lost their uterus to make greedy doctors richer.

The real ‘messiah doctors’ now belong to a vanishing tribe. People consider them as characters in history. Dr Devi Shetty of Narayan Hrudayalaya is one of the near-extinct species of doctors who talk and behave like angels of healing. He has dedicated himself to the service of mankind in health distress. He also donates liberally to worthy community causes. He is a rare proverbial doctor who has sacrificed personal pleasures to keep people heart-healthy. India is proud to have a demigod like him.

Once in a while, it seems there is a remote chance of the ’kickback doctors’ becoming humane creatures. This can only happen if the greedy inhuman health professionals reach physically and provoke the godly Dr Shetty for landing a couple of robust kicks on their behind along with a few tight slaps across the face for a period of at least one month without breakfast. May God come in their dreams to tell them to do so !