Doctor-Diagnostic Centre nexus: Plaguing health care sector since ages

By Meghna Nair

"Medicine is a profession where one can play God." That is probably the most clichéd statement one can come across.

In time of health crisis, doctor is synonymous with God to us. But what happens when the doctors have other plans?

A huge doctor-diagnostics centre nexus has been exposed in the North-Eastern state of Assam. According to a report published by Assam Tribunal, many doctors prescribed unnecessary tests to the patients in exchange of huge commissions.

But, this isn't the first time it is happening. In the past few years, several cases have come to the limelight wherein people have been prescribed expensive tests for no substantial reason.

A very grave instance was reported in Assam wherein a couple was forced to sell their newborn because they couldn't handle the medical expenses owing to the caesarian section the mother underwent. The height of irony is the fact that the incident happened in a government hospital in the capital city of Dispur.

The incident, although occurred in 2012, had brought up the issue of various kinds of nexuses existing between doctors and pharmaceutical companies, diagnostic centers etc.

According to the same report, doctors demand 30-50 per cent commission from the diagnostic centers by cash every month on MRI and CT scans.

Everyone knows that the field of medicine is well paying and that is one of the many reasons why it is one of the most sought after professions in India. Why then, are the doctors getting greedy and exploiting the common man?

"It is true that doctors get paid well, but there is a huge disparity between how much a doctor practicing in the city earns, as compared to his rural counterpart. The difference is not small. For example, if in cities like Delhi, a doctor is earning Rs. 60,000 a month, in rural areas the earnings would amount to as low as one third of this, i.e. roughly 20,000 rupees a month. That is a big disadvantage," says Dr. Abhishek Shankar, who is currently practicing in AIIMS, New Delhi.

Be it Delhi or Andhra Pradesh, these nexuses are omnipresent. A nexus of an Ahmedabad based pharmaceutical company and 40 doctors from Telangana was exposed in 2013. The doctors were pushing the sales of certain drugs in exchange of expensive gifts from the company.

A sting operation conducted by a private media outlet in 2014 revealed shocking details about the issue.

As reported by the media, the doctors struck deals with the pharmaceutical companies and provided monthly stats and details about the patients they tended to and took bribes ranging in lakhs.

"There are many frauds in this profession. Many people with fake degrees open up clinics and prescribe useless tests to the unassuming patients to rake in the commission. They are maligning the profession and are responsible for the distrust people have," says Dr. Rakesh Gupta, a practicing Orthopedician.

Are doctors alone responsible for this problem?

It is true that doctors do have a share in this, but the blame rests equally on the masses.

With changing times and the information available on the internet, there exists a general distrust among people towards doctors.

But, as they say, "half knowledge is a dangerous thing" and that is exactly the problem.

A headache becomes a migraine, a migraine becomes a cluster headache, and there is really no limit to the ever escalating presumptions of people. Then such a person goes to the doctor and he gets treated for simply a headache and not a cluster headache, the patient starts doubting the doctor's competence because he has already assumed the worst.

"These days the financial status of the middle class has improved and people now have less patience and increased paying capacity. They can afford to pay the consultation fees and the cost of the treatments.

When the middle-class man comes to government establishments like AIIMS, he has to wait for his turn among the working class people. This requires patience. Now, the thought process has become such that if at all they can escape the wait, and get things done, they'd not really mind paying a few bucks. That is where the problem starts," says Dr. Abhishek Shankar.

But how much is too much? How can the patient be more aware?

Diagnostics is a crucial branch of medicine. Today, the progress of this very branch has resulted in the possibility of curing myriad diseases which were a huge threat to mankind in previous days.

The advancement of diagnostics has been a boon. In government hospitals, the number of patients is huge. But the job of a doctor becomes easier with diagnostic tools.

Earlier on, the doctor used to talk to the patient, take detailed history, use his/her clinical acumen and then if needed, uses diagnostic tools.

But now, the number of patients has increased manifold and government hospitals do not let you devote too much time on one patient when you know there are 99 others waiting outside for their turn. This is where diagnostic tools come in handy.

"Diagnostics is very important and it helps you be efficient and accurate. With the help of these tools, diagnosing is easier and the room for error is significantly reduced. But then, some people misuse these facilities and scandals arise," Dr. Shankar says

But what should a patient do in case he/she isn't satisfied with the doctor's advice?

"When in doubt, go for a second opinion! And preferably go to a government run institution if you are afraid that the doctor is prescribing unnecessary tests," Dr. Gupta adds.

Each illness is different and different diseases also affect different people differently. One can only keep his/her eyes and ears open and try to approach government hospitals to avoid being victims of commercialization.