Doctors with conscience speak out
Corporate hospitals only want doctors who can help them earn more money.
NEW DELHI: In order to benefit the hospital and meet its commercial needs, one has to do things like keeping patients in the hospital longer than necessary, and doing unnecessary investigations and procedures (including angioplasty) since there was pressure from the management of the hospital. 

My conscience began pricking and I left the hospital- Dr Gautam Mistry, Kolkata, cardiologist who left a corporate hospital after seven years. 

A reference for angioplasty can earn a doctor Rs 30,000-40,000 – Dr Rajendra Malose, general practitioner, Nashik 

Recently, a young doctor who joined our department told me, “Sir, every month there is a meeting with the CEO. He asks me questions because instead of having a 40% conversion rate for OPD-operative as per the target, my conversion rate is just 10-15%. (Conversion rate means out of all patients seen by the doctor, how many are advised to undergo surgery or procedures. Rational doctors try to keep this rate low, but profit-driven hospitals try to maximise number of surgeries and procedures, even if they are unnecessary). He tells me that such low conversion rate will not do, and that unless I increase it, I will have to leave the hospital.” This young doctor will certainly surrender one day. To survive professionally, he will start doing 20-25% of additional procedures that are not required by medical logic. What choice does he have?”… And each corporate hospital has such targets! There is no getting out of it. – Super specialist from a metro 

Pharma companies are giving foreign tours and junkets to doctors. It happens under the pretext of medical study. Unfortunately, some doctors eagerly wait for the pharma company invitation for foreign tours- Dr HV Sardesai, physician Pune. 

Corporate hospitals only want doctors who can help them earn more money. As a result doctors who practise ethically cannot last there. I know of a hospital where if a patient is charged Rs 1.5 lakh, the doctor gets a mere Rs 15,000. 90% of the income goes to the corporate coffers. Corporate hospitals can advertise while individual doctors are not allowed- Dr Sanjay Gupte, gynaecologist, Pune, ex-national president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI) 

These are just a few of the shocking revelations by 78 doctors from small towns to every one of the megacities who are critical of the growing commercialisation of medical care. The doctors range from general practitioners to super specialists in corporate hospitals. These interviews that expose the corruption in private healthcare have been put together by SATHI (Support for Advocacy and Training to Health Initiatives), an NGO, to highlight the lack of regulation of the sector.

A report based on these interviews titled, “Voices of Conscience from the Medical Profession: Revealing testimonies by rational doctors about the reality of private medical practice in India” has been put together by Dr Arun Gadre, a doctor and writer with 20 years’ experience of working as a gynaecologist in rural Maharashtra, and Dr Abhay Shukla, convenor of SATHI who did his MBBS and MD from AIIMS.

The report will be released at the All India Institute of Medical Sciences (AIIMS) on February 26, in a function to be attended by AIIMS director Dr MC Mishra, senior gastrointestinal surgeon Dr Samiran Nundy of Sir Ganga Ram Hospital, and several of the doctors from across the country who have spoken out in the report.

The report is an English translation of the recently published Marathi report ‘Kaifiyat – pramanik doctoranchi’, which is being widely read in Maharashtra and is already into its second edition. An enlarged version of this report is soon to be published as a book.

“These ‘whistleblower’ doctors have exposed, perhaps for the first time on such a scale and in so many dimensions, the realities of the private medical sector today such as frequent irrational procedures and surgeries, the distorting influence of corporate and multi-specialty hospitals on ethics of the medical profession, and the growing grip of pharmaceutical companies on private medical practice. With testimonies by rational doctors from across India, this report can be an eye-opener for ordinary citizens as well as doctors, and could strengthen social support for much-needed moves to effectively regulate the private medical sector in India,” explained Dr Shukla.

According to him, the government is trying to dilute the Clinical Establishments Act of 2010 on the grounds that outdated laws have to be changed. ” The rules were passed in 2012 and the standards are yet to be formulated because of which it has not been implemented. Even before its implementation you are saying it is outdated. There is a strong lobby of the corporate health sector and the Indian Medical Association, the biggest lobby of doctors in India, that are trying to completely eliminate any kind of regulation. It is total jungle raj now. This is the larger policy environment in which we are releasing the report,” said Dr Shukla.

Public health activists have stressed the need to urgently step up regulation of the private health sector rather than dilute whatever little regulation exists. “Doctors have their lobbying groups like the IMA, which will speak of their interests. Society needs to speak up and lobby for the interests of the patients,” said Dr Shukla.