very true. No profession be it medical, education or religion ( Guru, saint,pujari,father,maulana) etc are any more noble.
Recently at 2 am my father became breathless. He was already not well for a month. I rushed him in ambulance to Hinduja. There they very promptly stabilized him in casualty but then they said they have no place in ICU and that we shud shift him.
We checked at seven hills who described the charges on phone itseld and told us to come over.Seven hills is little far and is in area which remains heavily traffic jammed. Then we called another hospital ( I want to avoid taking name) as same is headed by a good doctor and has good facilities ( but ethics???) and is only 7 minutes away from my house thus is nearest pvt hospital for me. They said they have a place in ICU. We rushed him there. They took him in to casualty and from there to ICU. Then I was asked to go and finish formalities of registration. There they surprised me by saying that I can not decide/ opt for a class I want for my patient. They said hospital policy is that emergency patients are given only Deluxe class ( room rate Rs 9500/- per day , doctor visit Rs 1700/- per visit and other charges high accordingly).
When I showed my reluctance , insited that there is no such rule which can allow this to happen in our country ( but in my heart I knew it is only in our country that common man are fleeced , duped,harrassed, armtwisted, blackmailed, illtreated and rich, who's who, VIP's are treated like maharajas ( see this hospital itself where there is luxurieos VIP lounge, but has badly kept dining room for relatives of patients behind in the dump area ) . The counter in charge then said u may pl. talk to Dr Yadav tomorrow and she may consider to down grade our room. With some reluctance I paid the deposit. From then own I kept following up with Mrs yadav and all others I cud approach and find contacts. I also carried my IT papers to support my case.
After 3 days keeping my request on hold they flately refused to do anything.
Ofcourse they have there policy and I have mine of activism and not to easily give in to arm twisting. I warned them politely. They stuck to their guns..of course it was worst then AK 47.
I had no choice but to take out my weapon given by beloved Bapu Gandhiji.
I made 3 posters :
1. so and so hospital have some heart.
2. Dr so and so fear God
3. stop armtwisting of emergency patients
One I pasted thru cello tape on my shirt , second I hired a poor boy and asked him to stand on gate and third I put up on my car parked on gate. I purposely selected time of 8 pm as 95 % of visitors are gone by that time as I wanted to avoid big scene ( did not want to use Ironman's hammer where gold smith hammer can work). I quietly started roaming in their palatial lobby. Slowly some relatives ( out of remaining 15 -20 ) before 7 pm there r more then 200 ) started murmuring, one or two gathered courage and came to me , appreciated, started telling their problems too, etc.. Hosp staff kept on looking from distance. They were in for a surprise and did not know what to do. Finally a team of 3 sr. managers who were leaving for home spotted me and came to me. The lady heading them was having extraordinary PR skills ( as if I am talked rough,loud,wrong language etc then I too loose my temper and then in short madness big scene is created) and sat clsoe to me, discussed the issue which I said :
1. I should have been told on phone that these are our terms and condition and charges when I had called up. After calling me with emergency patient, taking him in charge they can not
give me any rude shock?
2. They should have refused my request on first day as then I cud think of shifting patient to other hosp.
3. As a consumer I have a right to select the product and services of my choice and budget and know damages in advance. They have other rooms available then how can they insist that I must opt for the one which they would like ?
4. I also asked on what criteria / reasoning my request to down grade was refused and without even having look at my IT papers. Just whims or because I was not having some sr. bureaucrat, union to side me??
5. I highlighted that my patient was 88 yrs old Sr. citizen and that definitely deserved a soft approach.
She rushed in ( I can only believe she must have had to negotiat very hard for my case) and came back with an announcement that my request is granted. My bed charges came down by 50%. and doctors charges from whopping Rs 1700 to Rs 600/- per visit etc..
By the way there is a path lab in Santacruz east which has lowest charges and has written on board that we are lowest because we don't give any commission to doctors. And pl. note that there are no doctors who recommend that lab and only send to ( I will again avoid taking names)
Most family doctors for even small ailments refer in writing to specialists. The best option is to say if your roll is over then we will select the specialist / hospital and don't go with their letter. Even if specialist / hospital does not want you to over bill / do unnecessary surgery/ tests but they have to as the doc recommending wants big cut and if he does not get then next time he will not send Murga / bakra/ innocent client.
Caution: Many tests some times are necessary too to rule out and narrow down on problem so all negative tests do not mean that they were unnecessary.
Caution2 : I knew I am between good people ( may be little less ethical) and not in the hands of criminals but if I was in UP/ Bihar/ bureaucrat run place then I would have not done even this mild peaceful activism as there cud have been threat to patients life.
Caution 3: Let us prepare and arm ourselves with knowledge, procedures, policies, etc of medical profession so we are not taken by surprise. Someone can start a yahoo group / a discussion forum for common man who may need / are in need to share hospital experiences/ woes/expenses.Atleast that is our birth right as a free???? citizens of free??? nation.
Thanks and Regards,
Alok Tholiya (S.E.O.), M:9324225699 :
10th Road , Santacruz east, Mumbai 400055
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Date: Thu, 17 Feb 2011 01:05:56 +0530
Subject: [juhuektaalm] Your doctor gets 40- 60% kickbacks from pathology labs & other referrals!!
Corruption has many names, and one of these names is "commission". The government is no doubt corrupt… but civil society isn't innocent either. Professionals and businessmen of various sorts indulge in unscrupulous practices. I recently had a chat with some doctors, surgeons and owners of nursing homes about the tricks of their trade. Here is what they told me:
1) 40-60% kickbacks for lab tests. When a doctor (whether family doctor / general physician, consultant or surgeon) prescribes tests – pathology, radiology, X-rays, MRIs etc. – the laboratory conducting those tests gives commissions. In South and Central Mumbai -- 40%. In the suburbs north of Bandra -- a whopping 60 per cent! He probably earns a lot more in this way than the consulting fees that you paid him!
2) 30-40% for referring to consultants, specialists & surgeons. When your friendly GP refers you to a specialist or surgeon, he gets 30-40% from them.
3) 30-40% of total hospital charges. If the GP or consultant recommends hospitalization, he will receive kickback from the private nursing home as a percentage of all charges including ICU, bed, nursing care, surgery etc.
4) Sink tests. Some tests prescribed by doctors are not needed. They are there to inflate bills and commissions. The pathology lab understands what is unnecessary. These are called "sink tests"; blood, urine, stool samples collected will be thrown into the sink.
5) Admitting the patient to "keep him under observation". People go to cardiologists feeling unwell and anxious. Most of them aren't really having a heart attack, and cardiologists and family doctors are well aware of this. They admit such safe patients, put them on a saline drip with mild sedation, and send them home after 3-4 days after charging them a fat amount for ICU, bed charges, visiting doctors etc.
6) ICU minus intensive care. Nursing homes all over the suburbs are run by doctor couples or as one-man-shows. In such places, nurses and ward boys are 10th class drop-outs in ill-fitting uniforms and bare feet. These "nurses" sit at the reception counter, give injections and saline drips, perform ECGs, apply dressings and change bandages, and assist in the operation theatre. At night, they even sit outside the Intensive Care Units; there is no resident doctor. In case of a crisis, the doctor -- who usually lives in the same building -- will turn up after 20 minutes, after this nurse calls him. Such ICUs admit safe patients to fill up beds. Genuine patients who require emergency care are sent elsewhere to hospitals having a Resident Medical Officer (RMO) round-the-clock.
7) Unnecessary caesarian surgeries and hysterectomies. Many surgical procedures are done to keep the cash register ringing. Caesarian deliveries and hysterectomy (removal of uterus) are high on the list. While the woman with labour-pains is screaming and panicking, the obstetrician who gently suggests that caesarian is best seems like an angel sent by God! Menopausal women experience bodily changes that make them nervous and gullible. They can be frightened by words like"cysts" and "fibroids" that are in almost every normal woman's radiology reports. When a gynaecologist gently suggests womb removal "as a precaution", most women and their husbands agree without a second's delay.
8) Cosmetic surgery advertized through newspapers. Liposuction and plastic surgery are not minor procedures. Some are life-threateningly major. But advertisements make them appear as easy as facials and waxing. The Indian medical council has strict rules against such misrepresentation. But nobody is interested in taking action.
9) Indirect kickbacks from doctors to prestigious hospitals. To be on the panel of a prestigious hospital, there is give-and-take involved. The hospital expects the doctor to refer many patients for hospital admission. If he fails to send a certain number of patients, he is quietly dumped. And so he likes to admit patients even when there is no need.
10) "Emergency surgery" on dead body. If a surgeon hurriedly wheels your patient from the Intensive Care Unit to the operation theatre, refuses to let you go inside and see him, and wants your signature on the consent form for "an emergency operation to save his life", it is likely that your patient is already dead. The "emergency operation" is for inflating the bill; if you agree for it, the surgeon will come out 15 minutes later and report that your patient died on the operation table. And then, when you take delivery of the dead body, you will pay OT charges, anaesthesiologist's charges, blah-blah-blah.
Doctors are human too. You can't trust them blindly. Please understand the difference between:
· Young surgeons and old ones. The young ones who are setting up nursing home etc. have heavy loans to settle. To pay back the loan, they have to perform as many operations as possible. Also, to build a reputation, they have to perform a large number of operations and develop their skills. So, at first, every case seems fit for cutting. But with age, experience and prosperity, many surgeons lose their taste for cutting, and stop recommending surgery.
· Physicians and surgeons. To a man with a hammer, every problem looks like a nail. Surgeons like to solve medical problems by cutting, just as physicians first seek solutions with drugs. So, if you take your medical problem to a surgeon first, the chances are that you will unnecessarily end up on the operation table. Instead, please go to an ordinary GP first.