Time To Cure Medical Dishonesty

Mahesh Vijapurkar

A reputed single-specialty Mumbai hospital recently put the cat among the pigeons by setting up a huge billboard close to its location which proclaimed: “Honest Opinion. No Commission to Doctors”. The medical profession immediately got divided, and the Indian Medical Association (IMA) wanted it taken down.

It was a claim which simultaneously outed a long-held public secret of cutbacks for referrals, paid by a hospital to a doctor, by a specialist to a general physician, a pathology lab to a doctor. It is also one reason why health care has become expensive, not factoring in the inflated bills for cashless-insured patients.

The IMA wrote to the Asian Heart Institute they (IMA) may consider moving the Medical Council of India or Maharashtra Medical Council should its demand be not complied with. Not only did the hospital decline to oblige, but instead claimed a positive response from the medical fraternity.

The hospital wrote a letter to the Maharashtra Medical Council, the state health minister and medical education minster on June 14, signed by 50 doctors from the hospital. It said that cut practice had become widely prevalent, making it difficult for a doctor or a hospital to pursue the profession honestly.

Obviously, there are two sides to the debate.

One side’s claims amount to invoking the Hippocratic Oath by which the medical profession is to provide medical assistance even

selflessly, uphold ethical standards. The other was saying, no, it was an exaggeration of any mischief by a sundry few within the profession, and thereby sullying the image and reputation of the entire medical profession.

Going by media reports, including an article in the Lancet which gave space in 2013 to it with a headline, Tackling corruption in Indian medicine, and anecdotal evidence, it would be hard to find any middle ground between the two contradictory claims. The hospital, instead of being thanked for raising debate, was accused of cleverly advertising itself.

Let us assume that the billboard was an over-the- top generalisation, and that all doctors and all hospitals are not involved in kickbacks for referrals, but that the mischief prevailed only among a few, it was a challenge to be dealt with by the IMA to ensure ethical conduct. Instead, the IMA quibbled loudly.

It cannot pretend that the practice does not exist and say, as IMA president Dr Ravi Wankhedkar told The Times of India that, "What is being claimed in the billboard is the basic work of a doctor. It's like banks saying we don't rob money. Moreover, it indirectly alleges that others are unethical."

Of late, there have been far too many media reports on the incentives to the medical profession by drug manufacturers, on excessive pricing of medical devises, and even manufacturing of orthopaedic devises without licence. Food and Drug Administration Maharashtra has been exposing the over-pricing by hospitals, even reputed Trust-run, not just corporate, hospitals.

The least the IMA and the MCI should do in concert is to tell the profession that it needs to improve its practices so that cutbacks are a thing of the past, that the patients would not be put to severe hardships of having to pay inflated bills, and that the trust that people place in the private health care sector does not evaporate.

They cannot kill a patient with a huge bill after curing him of an illness.