Doctor-lab nexus: unethical, shameful

Doctor-lab nexus: unethical, shameful

The recent income tax raids on five diagnostic centres and two fertility clinics in Bengaluru have exposed what many people have always suspected -- an unholy nexus between doctors and these labs, which badly hurts the interests of patients. It has been widely known that many of the tests prescribed by doctors for patients are not really needed and some of them may not even be good for the patients. But doctors make patients undergo the tests, sometimes out of precaution, but increasingly because they get a commission out of the money patients pay for the tests. The raids have provided evidence of the sharing of this "loot" between unethical doctors and the labs. Documents seized have apparently shown that doctors got as much as 35% of the cost of MRI scans and 25% on CT scans and other tests. The rates may vary, but there is a commission for every test. Both the lab and the doctor gain, but the patient suffers. Labs also overcharge patients for these tests since they have to pay doctors their cut.  

The patient also has to pay the consultation fee and bear the cost of medicines and procedures prescribed by the doctor. Here, too, patients are short-changed because unnecessary medicines, surgeries and other procedures are prescribed. Recently, there have been reports about the highly inflated prices of stents and ear implants. It is clear that there is an unprofessional and unethical relationship between doctors, on the one side, and hospital administrators, pharma and medical equipment companies and diagnostic labs, on the other side. Patients have to foot the bill for this nexus to thrive, and even after being fleeced, many of them are left wondering whether they are getting the right treatment.  

What has been revealed in Bengaluru is true in all other parts of the country. Most patients are unable to bear the expenses of medical treatment partly because the costs are inflated by this nexus. Many, if not most, doctors are in a business that is run very commercially, without any ethical norms to guide them. The problems are different in the government-run health sector, but the patient suffers there, too. No one disputes that doctors and all others who offer their expertise and services to patients should be adequately paid. But the patient should not be exploited and wrongly treated, and her rights should not be violated. The medical profession needs a comprehensive and thorough clean-up in terms of its ethics and business practices. If it does not come from within, it may have to be forced on it.

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