07 July 2013
Complaints against the medical profession's unhealthiest procedure – the practice of giving cuts and commissions – has at long last reached the law–makers.
A doctor from rural Maharashtra, who was shocked to get a cheque of Rs 1,200 "for professional services" from a diagnostic chain, has filed a case against cut practice with the Maharashtra Medical Council (MMC), a quasi–judicial body governing the working of the medical profession. The first hearing in the case was held on Saturday.
The complainant, Dr H S Bawaskar who runs a hospital at Mahad in Raigad district, first wrote a letter in April to the Medical Council of India (MCI), which, in turn, directed the complaint to the state branch.
Cut practice is a term used to describe a commission that a doctor from another doctor, hospital or diagnostic gets for referring a patient for consultation, surgery or diagnostic test.
In March, Dr Bawaskar referred a patient named Sunita Veer from Mahad for a CT scan. "I told her she could go anywhere for a scan," he told TOI. The patient got a scan done at N M Medical Centre located in Sancheti Hospital, Pune.
Following this, Dr Bawaskar got a cheque for Rs 1,200 from N M Medical Centre. "When I enquired about the cheque with the centre, I was told that it is a payment towards professional fees for referring my patient to them," said Dr Bawaskar.
He wrote a protest letter to the Pune centre and asked it to return the money to the patient instead. The money was subsequently given to the patient.
On Saturday, Rahil Shah, CEO of N M Medical Centre, told TOI that the matter came to their notice only the day before. "It was sudden. At the council meeting on Saturday, we explained that there has been a misunderstanding. The council then said it would deliberate on the matter and decide," Shah said.
The MCI's code of ethics for doctors prohibits any rebates and commission to doctors. "The medical profession is already under attack for corrupt practices. The documents attached are a proof of giving kickbacks to doctors/persons sending cases to such centres as a systematic arrangement. This is openly paying a commission or kickback or cut to ensure that the institute gets an assured flow of cases to feed their centre," said Dr Bawaskar.
MMC chairperson Dr Kishor Taori confirmed that the council was looking at the complaint filed by Dr Bawaskar. "We will listen to the other side as well before giving our judgment," he told TOI.
But Dr Bawaskar says that his protest isn't against one institute or centre. "Over the years, many diagnostic centres have tried to offer me commission. One centre in Panvel sent me a note of Rs 500 that I promptly mailed back to them," he said. In Raigad district, he said, diagnostic centres have different rates for his patients. "My patients pay Rs 2,300 for a scan while patients of other doctor pay Rs 2,700," he said.
Nashik–based public health specialist Dr Shyam Ashtekar, who has written in support of Dr Bawaskar's complaint to the MMC, said that cut–backs hit patients hard. "Cost of care, as a result of cut practice, goes up by 30–40% for the patient. Moreover, hospitals or diagnostic chains are forced to conduct extra and unnecessary procedures," he said. He alleged that hospital software have inbuilt provision to allow for commissions and cutbacks.