How whistle-blowers are exposing medical malpractices in vain

"Nowadays malpractices have become creative… Sometimes even when there is no serious ailment, pretence of surgery is performed. Nothing is really wrong with the patient but he is given anesthesia and some stitches are put on the skin to show that an "operation" has been done. A huge, completely unnecessary bill is charged."

"One gets Rs 30,000 to Rs 40,000 just for referring a patient for angioplasty. Dead patients continue to be kept on ventilators until the anger of their relatives cools off. As soon as an accident takes place on a highway, seven to eight of these fellows go running to the site. Now even autorickshaw drivers are on the list of those receiving cuts from doctors and hospitals."

"They don't teach laser treatment in our medical colleges. We learn by trial and error, experimenting on patients."

"If a patient goes with my referral note he gets 30 to 40 per cent off on an MRI because I do not get any commission. One patient forgot to take my note and he was charged the full amount and the cut went to some third party."

These horror tales are not part of any fiction on India's medical system or a new episode of Satyamev Jayate but real life testimonies of private medical practitioners from all over the country. These are some of the voices from a first-of-its-kind survey of doctors done by a conscientious group of doctors and public health experts who want to promote ethical and rational medical practice in India.

In all, 78 rationally practicing doctors - general practitioners to super specialists working in corporate hospitals - have given evidence of malpractices with 37 of them giving consent to be identified. Called "Voices of Conscience from the Medical Profession", the study has been put together by Dr Arun Garde, a doctor and health activist from Pune and Dr Abhay Shukla, coordinator of SATHI (Support for Advocacy and Training to Health Initiatives). The study was released at the All India Institute of Medical Sciences (AIIMS).

These "whistle-blower" doctors have taken a bold step of exposing unethical practices in private medical sector such as frequent irrational procedures and surgeries, system of incentives and commissions, referral cuts, influence of corporate and multi-specialty hospitals on ethics of medical profession and the role of drug companies in driving private practice. In a sense, this compilation is like a public hearing on private medical sector, conducted by private doctors themselves.

Already writers of the report are being targeted and facing condemnation but the group of ethical and rational doctors is ready to take the movement ahead by encouraging more doctors to share their experiences and expose the underbelly of medical practice in India. An all-India network and a website are in the offing.

Mainstream medical bodies like the Indian Medical Association (IMA) are not willing to take the lead to clean up the system. They consider that there are just a few black sheep for which the entire profession is being tarnished, but the latest expose shows that black sheep in the profession are not just a minority. The government too appears to be reluctant to enforce any regulation of fees and services in private sector. The Clinical Establishment Act passed in 2010 has not been implemented, and the present government feels that such regulation is not needed. The draft National Health Policy 2015 praises the role of private corporate hospitals and states that any regulation may hamper growth of this sector.

As Dr Shukla put it, we need to address drivers of unethical and irrational practice of medicine in India beginning with medical education.