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Monday, April 4, 2016

Kickbacks by Diagnostic Centers and Revenue generation in Hospitals

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This post is purely based on my personal experiences that I have had in last couple of years. At no point of time do I demean the entire medical fraternity … as the saying goes …There are sure going to be some rotten apples in the basket.





Invariably a list of unrelated tests is prescribed by your doctor when you visit him when sick and we do undertake these tests without any questions for we are worried about our health. Now these tests are conducted in a diagnostic centers or testing centers where the name of reference doctor is noted and accordingly weekly or on a monthly basis a certain commission is sent across to the referring doctor…. This is known as referral fee. This information was given by the test center and as well as a doctor friend and this hold true for most doctors unless they specifically tell the test center to pass on this commission to the patients instead of them( The doctors I know personal are doing this).


Image Courtesy -Google Images

One such incident is while my wife had gone to meet couple of doctors while she was diagnosed with metastatic breast cancer. We met a particular doctor Dr.xxx who had treated a friend and he after checking my wife suggested PET scan to find out the spread of cancer at a test center. Then my wife went to meet another team of doctors lead by Dr.yyy suggested by my cousin who also suggested same test at the center. The cost of scan suggested by Dr.xxx was Rs. 25,000.00 and whereas the same test if we used the prescription of Dr.yyy would cost only Rs 14,000.00. The tests are the same and hence enquired at the test center why the difference in cost, we were informed that they had to pay a commission of Rs 11,000.00 for each patient referred by Dr.xxx for this particular test.

I was totally appalled by this kickback scheme being operated by the doctors and test centers thereby depriving the patients of their hard earned money. I did raise this point with Dr.yyy and he said… yes this is how it operates but me and my team do not want to fleece our patients who are already suffering with the dreaded cancer and hence we have told the test center to pass on this benefit to our patients. I do know few doctors consider this kickback as immoral and against the ethics of their profession. Medical Council of India clause 6- Unethical Acts in their Code of Ethics addresses the issue of rebates and commissions Read here ,but then as in most cases in India.. the rules are meant to be broken not followed

Most hospitals these days are run by corporates and everyone working there are under pressure to generate revenues for the hospital. Hence if you are a patient in a particular hospital you would be subjected to various tests to be conducted in the hospital even you have had these tests done earlier elsewhere. Also the doctors are told to retain patients in hospital as long as possible to gain revenues. This may sound callous but then this is happening for sure and I have overheard three doctors discussing about this while on a lift within a reputed hospital (They may have thought that I am a doctor too J looking at my appearance)


Gone are the days when individuals would aspire to become a doctor so that they are able to serve the mankind (though I know few doctors do just that and collect a nominal fee just to take care of their overheads for operating their clinics). These days people are becoming doctors with the aim of becoming rich fast and have high income on a regular basis. No doubts the money spent for becoming a doctor also has gone up exponentially in India with donations alone touching a crore of rupees and the fees between 40 to 50 lacs. It is quite natural with this kind of money being spent by an individual to become a doctor he is bound to succumb to the pressures of recovering the same and this directly affects the patients.

I am sure most of you would have experience similar instances and please leave your comments of these experiences.