How Punjab's doctors are now battling a drug problem

Getting kickbacks from the pharma companies, diagnostic centres and medical stores have become a serious issue in the country as doctors prescribe substandard and spurious medicines to make a quick buck. 

Pharma companies and diagnostic centres offer a variety of "incentives" for the doctors, including government doctors, for prescribing their brands and recommending tests from their labs. These include gifts, flats, foreign holidays, parties, cash payouts and even call girls. While pharma companies sometimes directly approach doctors through their medical representatives, at times distributors approach doctors as their profit depends on the sale volume.

The tacit understanding among the doctors, pharma companies and diagnostic centres has been in vogue from quite some time. However, the digitisation of banks has made the transaction records available at the click of a mouse. The scrutiny of the bank records of ten Punjab, Haryana and Chandigarh doctors by the Income Tax department has exposed how doctors flout the norms and bring disgrace to the noble profession.

The matter was brought to the notice of Punjab Medical Council by the Income Tax authorities, with date-wise details of the payments received through cheques from more than 22 multinational pharma companies. The Council issued notices on October 6 to the accused doctors and might even cancel their licences. These notices also have date wise details of financial transactions. The doctors received kickbacks ranging from Rs 7,000 to Rs 1.24 crore.

"Receiving financial transactions from pharmaceutical and allied health sector industry are in total violation of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 published in Part III, Section 4 of the Gazette of India dated 6th April 2002 (amended 14th December 2009)," the notices issued to the doctors said.

President, Punjab Medical Council, Dr GS Grewal says these cases are just a tip of the iceberg as getting kickbacks from pharma companies has become a system which exists in every state, and doctors openly flout the norms when their palms are greased.

"We have documentary evidence how multinational pharma companies bribed doctors. This is not to say that the small or Indian pharma companies do not bribe. Their pharma business is being run by corrupt medical practitioners who not only prescribe drug brands on prescription slips but also ask the patients to get health tests done at laboratories of their choice," Dr Grewal said.

The Medical Council of India (MCI) in 2013 had directed all registered medical practitioners to prescribe drugs with generic names as far as possible. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 also states that “Every physician should, as far as possible, prescribe drugs with generic names and he or she shall ensure that there is a rational prescription and use of drugs.”

Section 6.8 (Code of conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry) states that a medical practitioner shall not receive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext.

"Since there was involvement of a members of PMC, these illegal activities raise serious question in the mind of patients, general public and law abiding doctors regarding the functioning of PMC," says Dr Grewal.

Though the Punjab Medical Council created a sensation by exposing the corrupt doctors, the council is yet to expose the government doctors who regularly prescribe medicine brand names and recommend tests from private labs.