Many Indian doctors under pressure to meet revenue targets: Report


London, Sep 4, (IANS) : Many doctors working in India's private hospitals are under pressure to carry out unnecessary tests and procedures to meet revenue targets, says a report published in the journal The BMJ.

"Doctors who face pressure from hospital management to overprescribe surgeries or investigations fear for their livelihood," explained Gautam Mistry, a Kolkata-based cardiologist.

"Also they need to practise for a certain number of years, and by complaining they would be jeopardising their career," he pointed out.

Pune-based gynaecologist Arun Gardre said the main aim of multispeciality hospitals in India is to generate revenue and profits for their investors.

"In the race to earn higher profits, conscience takes a back seat, and doctors are encouraged to indulge in unethical practices," Gardre noted.

However, some doctors, including Devi Shetty, chairman of the Narayana Health Group which runs 32 hospitals for profit in 20 locations in India and abroad, disagree about the ubiquity of financial targets for doctors.

According to Shetty, setting financial goals for a doctor is not a common practice in India,
Narayana's hospitals do not set financial targets for doctors but do set performance targets to raise efficiency, Shetty said.

The Medical Council of India is responsible for institutional regulation of medical services, explains Bangalore-based journalist Meera Kay who wrote the BMJ report.

"But the MCI's reputation is in tatters -- its inability to collect data on alleged medical negligence and general failure to bring prosecutions instill no confidence," said Kay wrote in the report published on Thursday.

  

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Comment on this article

  • Amin Bhoja, Patte / Riyadh

    Sat, Sep 05 2015

    The report of revenue target is true to an extent!!!Sometime the normal delivery of a baby is getting complicated and finally it is transferred to cesarean!!!revenue!!!If you have a mild fever and cough there is unnecessary X-ray test blood test urine and stool test and more and more and the medicine....Sometime doctors knows the exact diagnose but it gets less revenue...so and so....A few to explain!!!

    DisAgree Agree [4] Reply Report Abuse

  • Raj, Udupi

    Sat, Sep 05 2015

    Precisely.. .hence I was suggesting that people must look at Ayurveda as an alternative.. find a good dedicated Ayurveda professional (not some cheats) in the locality.. you go for cough and the kashaya will ensure you dont get cough for next 1 year if not for ever... at the same time if you take modern medicine for cough, you catch cold and fever as a bonus... think...

    DisAgree [3] Agree [6] Reply Report Abuse

  • Sethu, Mangalore

    Sat, Sep 05 2015

    Out of 45000 or so graduating from Indian Medical Universities every year, 28000 plus are those who have paid hefty capitation fee ranging from 50-80 lakhs. Many of those may have questionable loyalty to their profession as commercial interests are always in forefront. Those who manage a pass with bluetooth technology have their PG seat ready. Government is primarily responsible to this fiasco as the state is gradually withdrawing from basic health delivery system and medical education. Next, the sole regulator in this field, the MCI, is highly corrupt and in shambles even after the exit of Dr. Kethan Parekh. They are the first culpable party for keeping medical ethics in the shelf as a commodity for sale. Greedy private lobby who is waiting for a space will fill the space and illiterate/gullible public remain as an opportunity for them. Government is supporting private lobby by enacting subjective provisions to CrPC like "The Karnataka Prohibition of violence against Medicare Service Institutions Act 2009". MCI do not hold data on medical negligence. Had they been, the data would have run to Terabytes or Gigabytes by now.

    Medical professional have now mastered in the art of manipulating medical records as a survival strategy. Indian medical degrees are no more acceptable in western countries. 15% of medical graduates from India would not clear USMLE. Deemed universities are allowed to set own entry norms, curriculum, fee structure, exam pattern and is no way answerable to any statutory authorities. In a hurry to make return/profit, all are running for deemed university status and it has become a golden goose for politicians. Medical graduates from Russia/China is flocking the scene to add our woes. The minority who hold Hippocratic oath to their chest and interest of patient before everything is always at the receiving end. Present trust deficit precipitated due to policy errors will stay for ever.

     Meanwhile, slogan shall be rewritten as "All for health by 2020!"

    DisAgree Agree [6] Reply Report Abuse

  • Peter Lewis, Kalmady/k s a

    Sat, Sep 05 2015

    I experienced it, unnecessary CT scan of my mother in a reputed Hospital in Udupi Dist even though x-ray.

    DisAgree Agree [3] Reply Report Abuse

  • Yash, Mangalore

    Sat, Sep 05 2015

    Sudhar Jao nahi tho Gabbar ajayega !!!

    DisAgree [2] Agree Reply Report Abuse

  • Charles D'Mello, Pangala

    Sat, Sep 05 2015

    After listening speeches of Dr. B M Hegde and with my own experience at two different hospitals. I do believe the report is correct. If medical insurance is there they try to loot the insurance company. In the future medical insurance companies may close or may be they increase premium which will not be affordable.

    DisAgree [2] Agree [8] Reply Report Abuse

  • yogesh, mumbai

    Sat, Sep 05 2015

    what some sr.docs did during their hey days???same thing-looting patients, made money and now chanting ayurveda...austerity and giving lectures to others?

    DisAgree [2] Agree [4] Reply Report Abuse

  • Raj, Udupi

    Sat, Sep 05 2015

    It is time for people to wake up and take the alternative therapy seriously. Ayurveda has simpler solutions to all ailments, except for some emergency nature of diseases, heart attack, cancer etc,... Of course big challenge is to find a genuine Ayurveda doctor as several quacks are around. Such fake doctors promise quick recovery and may induce drugs so, one has to go to reputed Ayurveda like kotekal, sri dharmastala, sri sri Ravishankar etc, they are said to be genuine and not commercial yet.… if you choose a wrong Ayurveda doc, you will end up losing faith in Ayurveda too..

    DisAgree [2] Agree [6] Reply Report Abuse

  • Lokesh, Mangalore

    Sun, Sep 06 2015

    Sorry Raj, not to be offended but alternative medicine can work only for certain extent. If you do not know let me tell you even Baba Ramdev who speaks as well as practice a lot ayurveda is attended hospitals recently. Ad you rightly pointed out for some conditions (particularly the modern disease) ayurveda don't have answers and patients have to go to Western medicine.

    DisAgree Agree [1] Reply Report Abuse

  • Raj, Udupi

    Mon, Sep 07 2015

    Lokesh
    Appreciate your comments, however pl note that you must never follow the claims of these baba or some TV ads.. their claims will only do harm to Ayurveda.. but if you are lucky to get a genuine practitioner, you will see the results – be it back pain, sugar, bp, piles, infertility what not. These are the common ailments people suffer with the most. But you need to have patience to wait for weeks or months and don’t mix modern medicines in parallel. Ayurveda cures the root and not superficial, hence it takes time. Even the latest diseases like chikoongunya etc has proven that Ayurveda recovered them in weeks, where as modern medicine patients suffered for 6 months of knee pain. However things like malaria, dengue and all are risky and better go for English. Most important is to find a decent doctor and nothing else.

    DisAgree Agree [2] Reply Report Abuse

  • Santan Mascarenhas, Kinnigoli/Mumbai

    Sat, Sep 05 2015

    Doctor is one who kills your ills by his pills, but, finally kills you by his bills.
    My wife had some urinary tract infection and our doctor told us to contact a Kidney specialist in Fortis hospital. After checking, the specialist told her to get admitted since he wanted to have some tests. After his tests, he referred her to Women specialist, Bone specialist, General Medicine and heart specialist. All conducted their related tests and she was in the hospital for 6 days. Finally with the tests and all doctors visits there, she got a bill of Rs 1,07,000. Fortunately she had medical insurance and we got Rs 96,000 from them. Insurance people are very careful while sanctioning amount, but here I think they were confused and paid major portion of the bill. I think some private hospitals are practicing the things mentioned in the article.

    DisAgree Agree [11] Reply Report Abuse

  • sriram, mangalore

    Sat, Sep 05 2015

    That is why it's scary to go now a days to doctors as they scare the hell out of you. The day is not far when you go to the doctor for a common cold and they'll say you have cancer and have to undergo chemotherapy (so that they can recoup their investments on advanced machines)....God save this country! And I've see the arrogance of the hospital staff if we try to enquire the status of the patient like "when will the doctor come?" or "can you let us know when we will discharge" they act as if they are gods and talk rudely and they blackmail the patients into staying in the hospital for longer than required so that they can milk the patients thoroughly.

    DisAgree [2] Agree [9] Reply Report Abuse

  • Antony DSouza, Bengalore / UAE

    Fri, Sep 04 2015

    Let the clinic or doctor come clean. If doctors has target, then let them be open and inform the legal authority and the patient. If unchecked it will continue and on the one hand patient has to suffer and pay money for no reason and the doctors will be having guilty conscience. Don't they know one day or the other the culprit will be caught? Then what a shame! This will be a worse sin taking in to account what kind of profession doctors have for so much is in the hands of doctors. These unrequired tests and surgeries may take a life or handicap patient. Take second opinion and look for a genuine hospital/clinic where this kind of practice is not rampant.

    DisAgree Agree [5] Reply Report Abuse

  • K M Prasad, Mangalore

    Fri, Sep 04 2015

    I fully agree with Dr Gautam Mistry. I have experienced such situations many times and hence endorsing his statement. Medical Practice has become more of a money minting business at the cost of naive , poor patients. I too have heard from doctors circle that their annual appraisal and promotions / increments are directly linked to the investigations , tests , X rays they prescribe. They do this unethical squeezing of innocent patients to further their personal goals. They put the patients in a tricky situations and indirectly force them to undergo many tests. If everything is decided by the test reports , what is the need for the so called highly qualified doctors? Are they for day light looting? Even Mangalore is not an exception for this menace. Especially the younger generation of doctors are the test savvy ones. Medical profession has lost the " holy profession" image and become a minting profession. It is high time , elderly professionals take stock of the situation and try to educate or imbibe values to the younger generation. Let them get the best wishes and blessings of the patients and not their CURSE.

    DisAgree Agree [5] Reply Report Abuse

  • A. S. Mathew, U.S.A.

    Fri, Sep 04 2015

    The medical industry in the world, like in the U.S. is the biggest rip off of highway robbery in the world. India is simply following the U.S. medical business technique.

    That is far worse than the oil game played by the OPEC nations of the world through controlling the production data, and increased the price at their whim and fancy.

    How many tests are ordered by some doctors? If a doctor is prescribing medicines and ordering a battalion of tests, the doctors will get commission from them all. So, the vast majority of the so called heavenly-sent doctors are simply killing people with the through excessively drugging them, also through putting the excessive burden of financial ruin rather than playing the role of healing them.

    I used to go to a doctor in 1980, the local doctor's charges of a GP was less than $ 8.00, but now the see the same doctor, after seeing him for less than 5 minutes will come over $ 130.00. How, in the world, this can be justified?
    Also, they want to see us every month without any reason through creating a fear in us "if we don't see the doctor, we will die".

    DisAgree Agree [9] Reply Report Abuse

  • Maxim, Kukude

    Fri, Sep 04 2015

    Many Indian Doctors Conduct Fake Clinical Trials from Patients..To get Kickbacks

    DisAgree [1] Agree [6] Reply Report Abuse

  • Anil, Udupi/Mumbai/Dubai

    Fri, Sep 04 2015

    Even in UAE, many doctors are getting hefty commission when they exceed their target. They simply instill fear in you

    DisAgree Agree [7] Reply Report Abuse

  • Jossey Saldanha, Mumbai

    Fri, Sep 04 2015

    MBBS Seat @ 50 lacs
    MD Seat @ 1 Cr.
    How do they recover this amount ...

    DisAgree Agree [13] Reply Report Abuse

  • Ravi B Shenava, Mangaluru

    Fri, Sep 04 2015

    Many Hospitals follow the principle of "Affordability" while preparing the bill of any patient. This means if two patients with same disease are admitted to same hospital, the patient with meagre means is charged at normal rate ( pl note that NOT at concessional rate), but if another patient takes deluxe room and if his financial background is found to be sound then he is charged three to four times more than the other ordinary patient for same kind of treatment-operation & medicines. I myself was a victim of one such Affordability principle. Without knowing I had taken deluxe room and I was charged exorbitantly. When I discreetly enquired with the Billing clerk who was a friend of mine, he confided about such open discrimination in billing in the name of Affordability. If the patient is an employee of Multinational company or IT-BT company and having Insurance cover from his employer then the Bill is inflated too much. If the patient questions then he is told that - anyway it is your company which is paying, so why you are bothered about inflated bill ?
    Now a days a separate Marketing Manager is appointed in all private Hospitals to ensure that the patients are fleeced to the bone. The Billing clerk is directly under the jurisdiction of Marketing Manager and not under the Doctor who performs Operation.

    DisAgree Agree [7] Reply Report Abuse

  • Jossey Saldanha, Mumbai

    Fri, Sep 04 2015

    Who is HONEST ...

    DisAgree [1] Agree [5] Reply Report Abuse

  • Jamal, Mangalore/UAE

    Fri, Sep 04 2015

    Whatever may be the reason poor patients suffer mentally and financially.

    DisAgree Agree [28] Reply Report Abuse

  • True Fact, Mangalore

    Fri, Sep 04 2015

    suffer even physically..

    DisAgree Agree [5] Reply Report Abuse

  • Lokesh, Mangalore

    Fri, Sep 04 2015

    Nothing new in this report. We all know in a private practice (particularly the self practice) it is very common not only in India but also in Countries like Singapore, Ireland, UK, France, Germany, Australia, the US and China. That's how private practice gets a huge profit. There are doctors who justify the tests/procedures he carries out and it is a grey area in some cases to actually say it was a unnecessary test/procedure but most of the cases there are clear cut evidence that this test/procedure really unnecessary. I don't think we can do much about it.

    DisAgree [3] Agree [20] Reply Report Abuse


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