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Patients or victims? — PART II Chitleen K Sethi Tribune News Service Chandigarh, October 31 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 doctors”, 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 fee”, 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 capacity”, 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. (To be concluded)
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