Several doctors from across the country came together on Wednesday to voice their concern against “cut” practice in the profession claiming that the problem was deep-rooted and involves corporate hospitals, private doctors, radiologists and pathologists, with each one relying on the other to refer patients for commissions.
The state government has now formed an expert committee to frame guidelines for punishment for the practice. “We will submit the draft of the act to the Law and Judiciary department and then to the state Assembly to get it enacted,” said Dr Pravin Shingare, director of the Directorate of Medical Education and Research (DMER).
Currently, only the Maharashtra Medical Council (MMC) has the powers to suspend or cancel licences of doctors found offering commission for referring patients to them.
The debate comes at a time the Asian Heart Institute in BKC has put up an advertisement near the Chhatrapati Shivaji International Airport’s domestic terminal stating: “Honest opinion. No commission to doctors”.
The Indian Medical Association (IMA) asked the hospital to pull down the hoarding claiming that it maligned the medical community. On Wednesday, the hospital that hosted the doctors for a debate, put up 10 more banners across Mumbai stating the issue needs to be discussed.
“It was a well-thought decision to talk about the cut practice. It has become very rampant. If this practice is removed, it will reduce the patients’ medical costs by 20 per cent,” said Dr Ramakant Panda, director at the Asian Heart Institute.
The hospital has garnered support from radiologists in the Mira Bhayander Municipal Corporation and Nashik areas. Under the practice, a hospital, pathologist or specialist pays another doctor for referring a patient. “The commission, in money or kind, may also lead to unnecessary investigations that a patient does not require. Our association has decided to stop this practice and refuse commissions,” said Dr Vikrant Desai, radiologist and vice-president of the IMA in Mira Bhayander.
The Asian Heart Hospital will create a website to promote ethical practices in the medical field. “There are a lot of young doctors who unwittingly indulge in the practice because everyone does it,” Panda said.
According to Dr Gautam Sen, chairman of HealthSpring clinics, high cost of medical education has also encouraged young doctors to take up the practice. “Medical education needs to be looked into by the government. The fees in private colleges are so high that as soon as a doctor graduates, he thinks of recovering it fast,” he said.
Dr Tamara Zweck, a physiotherapist who has been practising in India for 10 years, claimed she was offered a commission for referring patients. “It is hard to say no. But I had to practice ethically. If you don’t offer commission, no doctor refers patients to you,” she said.
Dr Himmatrao Bawaskar, head of the Bawaskar Hospital in Mahad, has complained against the “cut” or commission practice to the MMC twice. “Stopping the practice will reduce unnecessary investigations,” he said.
According to Samiran Nundy, editor of Indian Journal of Medical Ethics, next year, the Oxford University Press will publish a book on the issue of “cut” practice.