Dr. Sulekh Chand Jain
This is a major industry where huge profits are made very quickly every day, mostly by cheating the customers and users. A significant number of Jains are engaged in this value chain as physicians, service providers, hospital owners and workers, clinic and nursing home owners, chemist and drugstore owners, drug manufacturers, wholesalers, and retailers, and the list goes on.
The following news item was forwarded to me recently by a friend of mine. The message is very clear and self-explanatory. I feel most probably Jains are not immune from this menace, either.
“Do Not Get Sick In India”.
“Every doctor affiliated to a hospital in India must perform a certain number of surgeries and physicians must refer a certain number of patients for laboratory tests, X-rays and MRIs, endoscopies and ultrasound etc. If not they are removed from the hospital registries and premises…Treatment is given not according to the disease but according to the wealth of the patient.
Most of these observations are either completely or partially true. Corruption has many names. 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 shared:
In general, kickbacks for lab tests happen about forty to sixty percent of the time. 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 - commissions happen about forty percent of the time. In the suburbs north of Bandra - a whopping 60 percent! A single GP probably earns a lot more in this way than in the consulting fees that you pay.
30-40% for referring to consultants, specialists, and surgeons: When your friendly GP refers you to a specialist or surgeon, he gets 30-40%.
30-40% of total hospital charges: If the GP or consultant recommends hospitalization, he will receive a kickback from the private nursing home as a percentage of all charges including ICU, bed, nursing care, and surgery.
“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” and the blood, urine, and stool samples collected will be thrown away.
Admitting the patient to “keep him under observation”: People go to cardiologistsfeeling 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 three to four days after charging them a fat amount for ICU, bed charges, and visiting doctors fees.
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 tenth class 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 twenty 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) around-the-clock.
Unnecessary caesarian surgeries and hysterectomies: Many surgical procedures are done to keep the cash register ringing. Caesarian deliveries and hysterectomies (removal of uterus) are high on the list. While the woman with labor-pains is screaming and panicking, the obstetrician who gently suggests that a caesarian 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 “cysts” and “fibroids” that are in almost every normal woman’s radiology reports. When a gynecologist gently suggests womb removal “as a precaution,” most women and their husbands agree without a second thought.
Cosmetic surgery advertised through newspapers: Liposuction and plastic surgery are not minor procedures. Some are life- threatening. But advertisements make them appear as easy as cosmetic procedures like facials and waxing. The Indian medical council has strict rules against such misrepresentation. But nobody is interested in taking action.
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.
“Emergency surgery” on dead bodies: 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 fifteen 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, anesthesiologist’s charges, and many more fees that were unwarranted. What an insult to take advantage of the sick and grieving.”
Doctors are humans too. You can’t trust them blindly. Please understand the difference between young surgeons and older ones. The young ones who are setting up nursing homes, for example, 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 operating table. Instead, please go to an ordinary GP first.
Now you decide, is this behavior consistent with ahimsa?
