Medical Profession --- ethical business or unethical business
Doctors are next to God and people believe them totally, and follow their instructions without any doubt about the treatment or medicine when they are critically ill. The profession once called as a noble profession and they take care of the health of the people and will not give any medicine without purpose. They will never ask you to do the clinical test unless it is so warranted. It is green in my mind, every household will have a family doctor and he knows about the entire family history.
In the 1990s the doctor profession has changed into business but with ethics. There is specialization and the charges were gone up but everything is within a limit. When we go to a doctor, he will be able to diagnose us by checking our pulse and lab testing are at a minimum.
After 2000, there comes corporate hospitals and the hospitals were built like star hotels and the profession has really become a unethical business. As soon as you go a doctor, the first thing they will ask for a variety lab test whether it is required or not and the treatment will start only after that. The medicines prescribed to us are also at exorbitant cost and the medical treatment becomes unaffordable for many. I am not generalizing the statement but the good compassionate doctors and hospital are reducing day by day. There is the specialization for every part of the body and science has advanced a lot and medicines are available for every kind of illness. With profit-making being their main motive, private hospitals are pushing doctors through a system of incentives and disincentives to over-bill using whatever means – ethical or unethical – they can think of. Targets are also fixed for each doctor and they are forced to achieve the same. One of the reasons for such action is due to the increased cost of medical education with the number of seats in the Government college are limited and many medical aspirants opt for private medical colleges by paying exorbitant capitation fees. This makes doctors vulnerable to the whims of private hospitals that pay good money to their empanelled doctors – needed to recover high investments in medical education.
Now let us see the cases reported regarding excess charges, wrong treatment, carelessness etc.
Some of the common tactics used by money-minded Indian doctors to cheat or fleece gullible patients of their hard earned money are:
- Prescribing more tests than necessary - to be done at preferred labs for hefty commissions. There are instances that the test is not conducted only a fake result is given.
- Keeping you admitted at hospital rooms even if you’re fit to be discharged.
- Prescribing expensive medicines/vaccines when cheaper and quality substitutes are available.
- Charging patients at different rates for the same treatment according to the room they select.
- Fake operations
- Use of stent in heart disease treatment even if not needed – 1 stent may cost a patient anything between Rs. 60,000 -100,000 or more depending upon the status of hospitals or pockets of gullible patients.
- Gynecologists at private hospitals are well-known to force pregnant women to go for C-section which pays better than normal deliveries.
- Last but not the least, is luring poor and uneducated people for agreeing to donate organs, kidney in particular, for which there is no dearth of high paying customers as highlighted by the arrests at Hiranandani Hospital in Mumbai and Apollo in Delhi.
There are only a few cases reported and become public. Many a time we blame it on our fate. The recent incidents are as under.
Case No.1
Fortis Gurgaon marked up medicines, consumables billed to dengue patient as much as 1,700%. The markups were the highest in consumables at as much as 1,737%. Around 96 types of consumables were used on the patient. For medicines under price control, Fortis marked up the prices between 5% and 350%. For those not under price control, the family was billed anywhere between 10-200% more than what the hospital had paid distributors for the products. Consumables like some brands of disposable syringes were billed at a maximum retail price of Rs 200.
Read more at:
Case no 2.
Baby boy found to be alive after Delhi hospital declared him dead. Police in Delhi have launched an investigation after a baby that had been pronounced dead by doctors was found to be moving in a body bag as his parents prepared to deliver funeral rites. Two doctors have been sacked from Delhi’s upmarket Max hospital in Shalimar Bagh, where the boy and his twin sister were born prematurely at 22 weeks last week. The girl was stillborn and the boy was in critical condition; soon afterward, doctors pronounced him dead.
Case no 3
Ever wondered why your doctor always referred you to a particular laboratory for medical tests? The reason is the lucrative nexus, proves the doctor-lab nexus unearthed in Bengaluru. Income-Tax officials have unearthed a major multi-layered nexus between medical centers and doctors and an undisclosed income of Rs 100 crore after searches at a few IVF clinics and diagnostic centers here, the department said today. It claimed doctors were being paid "for referring medical tests". IT sleuths, the department said, have seized about Rs 1.4 crore in cash and about 3.5 kg of jewelry and bullion during its three-day action against two in-vitro fertilization (IVF) centers and five diagnostic centers.
Case 4
MUMBAI: The Maharashtra government has filed complaints against 37 hospitals across the state for reusing single-use medical devices and overcharging patients, said minister for consumer protection Girish Bapat. The government is also working on ways to refund patients who were unfairly charged for reused devices, he announced in the legislative council.
Case 5
NEW DELHI: Some of the country's most prestigious hospitals are under the scanner of the National Pharmaceutical Pricing Authority (NPPA) for allegedly overcharging patients for stents. The regulator has initiated a probe against hospitals including PGIMER Chandigarh; Lilavati Hospital in Mumbai; Max Hospital in Saket, Delhi; Metro Hospital in Faridabad and Ballabhgarh (Haryana); and Ram Murti Hospital in Bareilly (Uttar Pradesh).
Action initiated by the Government
The government of India has made tremendous efforts to reduce prices of life-saving medical devices and medicines which are still being heavily charged by hospitals. As per law, packaged commodities cannot be charged over their maximum retail price or MRP.
Do we know the National Pharmaceutical Pricing Agency has classified the following devices as packaged commodities and the price of these medical devices are capped?
ü Stents,
ü Angioplasty catheter,
ü breathing circuit,
ü balloon device,
ü fabric natural fiber,
ü guide wire,
ü IV catheter,
ü hands-on gloves
ü and blood collectors etc.,
By classifying under the category of packaged commodities it is strictly prohibited from being sold over their printed MRPs. As a consumer, we should aware of this information.
Further, Prices of several medicines have been fixed under the National List of Essential Medicines 2015 and the medical devices rules of 2017 have brought various regulations to control the price and make it more affordable for patients in India.
How to Proceed if Hospitals overcharging for services
In cases we observe that the hospital is over changing us, then we should initiate a complaint against the hospital enclosing the copies of the documentary proof including bills and prescription in writing to the Management of the hospital to enable them to take corrective action immediately. If you do not get any favorable response, then we can file a complaint with the Local Medical Officer of the Government for redressal.
The Insurance Company is to be informed to enable them to rectify the cases of overcharging as they are also affected party of overcharging.
We can contact the Office of the Controller of Legal Metrology in our state either through a letter or an email and the State or Central Health Ministry which can address our concern. Finally, we should take up the matter with the Medical Council of India and the Drug Council of India.
Besides all, a complaint may also be filed with Consumer court for redressal. For all the above action we required keeping the following documents to prove our case
Ø Prescription of doctor for the patient.
Ø Bills from the hospital.
Ø Proof of market price or MRP of the particular product.
Ø Receipts with the signature of hospital representatives.
Ø Identity proof of the patient.
The way forward
ü Medical Council of India must come with the system of standardizing treatment protocol. They should also conduct surprise checks at the hospital and take action against the unscrupulous doctors/ Hospitals.
ü The Hospitals and treatments should be more transparent so that excess charges can be avoided.
ü Increase the seats in the Government College to make the education an affordable one.
ü Mandatory recording, archiving and sharing of the recording with patients or their representatives.
ü The data regarding the successes rate of each specialist regarding their performance.
ü Government may also consider a regulatory authority for the private hospitals/doctor to control and monitor their performance and take action against defaulters.
Conclusion:
Whatever, we discussed, there are some practical difficulties in fixing the Doctor and Hospital as it is so technical and decisions to be taken at a difficult situation and there may not be any time left with the doctor to discuss the issue and take a calculated risk in treating a patient. We only pray God that he should prevail on them to understand the noble profession they have selected while treating the patients.
