media reports are corroborating such a perception. For instance,
a few months ago, a leading daily has carried a series of
reports on growing nexus between hospitals and the diagnostic
centers. This nexus is resulting not only in fleecing the
patients, but also in submitting them to unnecessary diagnostic
tests. There were also instances where doctors have subjected
their patients to complex surgeries without factoring their
old age, all for a quick profit. This is in gross violation
of the Indian Medical Association's Code of Ethics, which
clearly states that a physician must uphold the dignity
and honour of his profession, the prime object of the medical
profession is to render service to humanity; and reward
or financial gain ought to be a subordinate consideration.
Sadly, not only have kickbacks from diagnostic centers became
common, but numerous media reports also suggest that there
have been instances of gross medical neglect and high incidence
of corruption in health care. The CGHS scam is one such
glaring instance. However, the response from the medical
fraternity to growing incidence of corrupt medical practices
has been a deafening silence.
indifference will only result in outside agencies/government
stepping in. More state regulation will only result in more
corruption and further complication of the existing problems.
Therefore, doctors, diagnostic centers and hospitals must
start taking steps which will facilitate quality health
care to all the patients at reasonable costs. We need to
remember that in spite of declining ethical standards, there
are many honest and competent doctors, pathologists and
radiologists. They should come together to identify and
standardize best medical practices. An internal institutional
mechanism in hospitals must be created to oversee the various
medical practices. Similar to ombudsmen in banks, every
hospital can have an internal vigilance officer of credibility.
An independent accreditation system to rate various hospitals
can be examined. The accreditation mechanism could be structured
along the lines of CRISIL, which rates financial institutions
and is respected by the government and corporate sector
alike. The accreditation system has many other advantages
such as identifying best practices and the possibility of
replicating them in other hospitals. This will also help
patients make informed choices, and will propel various
hospitals and individuals to upgrade their capacities.
sector is playing a dominant role in medical care, accounting
for 80% of the ambulatory care and 60 % of patient care.
This role of private sector is bound to grow, and the doctors
will have to ensure that the profits of hospitals will not
be at the cost of the community and patients. Introduction
of ethics as a part of curriculum will equip medical students
to deal with complex issues while delivering medical care.
In a country where the 'out-of-pocket' expense on health
care is one of the highest in the world, the decline in
the ethical standards and the loss of confidence in health
fraternity does not portend well for social stability. The
medical profession would be wise to seize the initiative
and set things right by establishing credible institutions