Target-driven docs have little cure

[Guest guest]

The conditions in mercurial materialism have started deteriorating upto this extent that even our colleagues donot spare the junior ones, especially in the so callled big cities. I have an experience of visiting our medical college very senior teacher (Ex) for an expert obstretical opinion for the wife of a close friend.We used to keep him in high esteem for his outspoken opinion. The patient was having her second pregnancy in 2nd trimester with moderate grade anemia. We did not find anything abnormal. It was a routine check up.

 

But we were wonder struck when we had his melodramatic mannerisms depicting the grave conditions of the patient, warranting immediate hospitalization in XX hospital and so on and so forth.

 

I,especially personally felt ashamed to consult the gentleman. I could not help telling my senior teacher bluntly in one sentence. Money is important but no melodrama, Sir. Four chapptis in life and two handful of ashes in death-That is all.

 

Such dramas can not last longer.Truth has the birthright to emerge out. “I am referring a brain dead patient to you. I have made enough money from him, now you can keep him for a few days,†is his request.

 

I can quote many examples now unfortuantely.

 

http://www.tribuneindia.com/2009/20091101/main7.htm

 

Patients or victims? — PART IITarget-driven docs have little cureChitleen K SethiTribune News Service

Chandigarh, October 31A private doctor in Baddi calls up his medical college classmate serving in a private hospital in Mohali. “I am referring a brain dead patient to you. I have made enough money from him, now you can keep him for a few days,†is his request.

What has happened to the Hippocratic oath, one wonders.

Doctors working towards meeting “targets†are almost every corporate hospital’s success mantra. The salary of a doctor, his promotion, his foreign trips, his media exposure can all depend on the number of surgeries he performs, stents he implants, tests he prescribes...or in other words how “lucrative†he is to the organisation.

“It is said about a cardiac hospital here that one should never go to them towards the month-end when doctors are under tremendous pressure to meet targets. There is a possibility of their operating on perfectly healthy persons,†said a Mohali resident.

Such “target doctors†are paid a certain amount as retainership for a fixed number of procedures. If the doctor is unable to bring in this minimum number of patients, his retainership is liable to be reduced accordingly. In some hospitals, this target is fixed for the whole year but in some cases it has to be met each month. And if a doctor wishes to earn beyond his retainership, he has to somehow get more patients.

“The result invariably is that gullible patients going for out-patient check-ups for minor problems end up being told how serious their condition was and how important it was to get admitted. Once the patient is admitted, he is the goose that would lay a golden egg everyday for the hospital,†said a doctor working in one such hospital. Other than “target doctorsâ€, hospitals also have medical officers employed on fixed salary. They are generally ill-paid and in several cases not even proficient. Hospitals are known to have on their rolls doctors with questionable degrees and even unrecognised degrees. An allopathic hospital here has Ayurveda doctors working for it as senior residents.

Yet another category of doctors in private hospitals is the “consultants†category. They are not on the rolls of the hospital but are merely associated with them. The understanding with them varies from hospital to hospital but most of them allege that while the patient is charged a large amount as “consultant feeâ€, what they get from the hospital is slashed to 30 per cent of what the patient has paid.

Doctors working privately are otherwise rarely on the receiving end. Pharmaceutical companies offer them the world to convince them to prescribe their medicines and starting from the television, the fridge, the washing machine, down to the pen they are using are “gifts†from companies. For doctors with higher “prescription capacityâ€, foreign trips, attendance to international conferences, memberships to exclusive clubs are provided for by these companies. Interestingly, such medicines are rarely available beyond the drug store within the hospital or clinic.

 

Thank you very much.

With warm personal regards,

 

Nikhil

Dr. Surender N. Gupta,

MBBS; PGDHHM;PGDMCH;PGCHFWM; FAIMS;MA (Phil);MAE (Epidemiology) Faculty cum Epidemiologist,

Regional Health and Family Welfare Training Centre, CHHEB, Kangra-Himachal Pradesh, India. Pin-176001.

01892-265472 (Fax); 01892-263472 (Office)Mobile: 094181-28634.

E-mail IDs: drsurendernikhil

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