by Laxmi Yadav
With an aim to curtail the ‘cut practice’ in medical profession, the Maharashtra government has decided to introduce Prevention of “Cut practices in Medical Services Act, 2017” soon.
A 9-member committee has been formed by the government to study other countries’ regulations for preventing cut practices including anti kickback laws in USA and UK and suggest measures to be incorporated in the proposed Act.
Headed by past Maharashtra Director General of Police Pravin Dixit, the committee comprises of Dr. Avinash Supe, Director of Medical Education and major BMC hospitals, Dr Sanjay Oak, director of Prince Aly Khan Hospital, Byculla, Dr Abhay Chowdhary, president of Maharashtra Medical Council, Dr Ramakant Panda, vice chairman of Asian Heart Institute, Mumbai, Indian Medical Association (IMA) representative, Dr. Yeshwant Amdekar, pediatrician, Dr. Amit Karkhanis, dermatologist, Dr. Himmatrao Bawaskar, Mahad.
At the first meet held on June 27, the panel discussed certain provisions of the proposed Act in detail which are as follows:
Section one contains definition of the Act which reads any person believed to be medical experts having received a patient for treatment, refers him to another medical experts, hospitals, laboratory for further treatment/examination/ tests and in turn receive any pecuniary benefits from such medical experts/hospitals/laboratory, would be committing an act of indulging in “Cut practices in Medical Services.”
Section two says cut practice in medical services is an offence and would be charged under cognizable offence tried by JMFC, 1st Class. Any person who indulges in such act repeatedly, would be treated as repeat offender.
Section three deals with punishment for the offence. It reads punishment for the offence of “Cut practice in medical services” would be simple punishment up to three months and fine up to Rs.5,000. Repeated offender would be punishable by simple imprisonment up to six months and fine of Rs.25,000.
The committee was formed by the state government following Dr Ramakant Panda’s representation to Directorate of Medical Education and Research, Government of Maharashtra over rampant growth of cut practice in medical field.
Dr Panda’s Asian Heart Institute had put up a poster stating ‘No commission. Only honest medical opinion’ in the city which invoked sharp response from IMA. The hospital has also installed 10 banners in the city in response to IMA’s warning to remove the first one.
Reacting to IMA remark, Dr Panda said that instead of protecting wrongdoers, IMA should sensitize its members on the need to do away with cut practice. Its not that all of its members are engaged in such practice. There are a number of doctors who have never involved in it, he added.
He said “We have found that at least one third of the patients who were asked to go for angioplasty or bypass surgery did not need it. The expense of treatment will decrease by 25% if cut practice is curbed.”
Considering the rampant growth of cut practice, Asian Heart Institute has initiated debate on the issue. A number of medical professionals including Dr Gautam Sen, Dr Vikrant Desai, Dr Sanjay Nagral, Dr Himmatrao Bawaskar, Dr Devi Shetty, Dr GN Rao, Dr. Soma Raju, Dr Srinath Reddy, Dr Samiran Nundy etc has extended their support to the hospital crusade against cut practice in medical services.
Over four decades cut practice has moved from the fringe of medical practice to its core with 70-80% doctors engaging in the practice. A number of doctors were forced to take up such practice even though they did not want. New pathologists, specialists opening up their labs and clinics do not get patients until they pay certain amount to the medical practitioners who refer patients to them, said Dr Vijay D’Silva, medical director at the Asian Heart Institute.
Dr Sen attributed rising cost of medical education to the cut practice. Most of the candidates belonging to middle class take a huge bank loan to pursue medical education. Once they enter medical practice, they are left with no option but to engage in cut practice to get patients to repay their medical loan. Multipronged approach is required to tackle the issue. Making medical education affordable is one of them.
Dr Samiran Nundy will come out with a book “Healers or Predators”, to be published by Oxford University Press next year, with about 40 chapters; which speaks about this issue. India needs strict monitoring bodies that dole out tough punishment for wrongdoing, he added.