No matter which clinic, which hospital, or which nursing home you visit in India, they always have patients pouring into them in large numbers. The major reason for it being, poor doctor to patient ratio. In India there is just one doctor for 1700 people (Source). But that is not what I am most concerned about.
The bigger problem which exists right now is, that one doctor, exploiting his/her 1700 patients. I need not tell you about how doctors in private clinics and hospitals recommend unnecessary tests and operations. Anyone who would have gone for treatment or accompanied his/her friend or family member at those private hospitals must have felt it at some point or the other (or maybe always).
But did you know that it’s completely NOT THE FAULT OF THE DOCTOR?
It is the commercial setup of the hospitals and the way they run, which compel the doctors to push their patients to shed that extra money which was not required.
Dr. Martin Makary, a well renowned surgeon at John Hopkins Hospital, Baltimore, USA, and also the author of a bestseller by The New York Times, Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Healthcare, said in an interview, “They’re told they need to do so many operations in a month. Sometimes doctors tell me they get text messages and emails, saying, ‘You need to do so many operations by the end of the month.’ They’re expected to do more, often with less resources. Doctors don’t like blind triggers that result in overtreatment. They want to practice medicine the way it was intended to be practiced – individualized in care.” (Source)
The directors, managers and CEOs of the hospitals set a minimum target for the doctors, i.e. they have to see a fixed minimum number of patients and also ensure that those patients undergo a certain number of tests/treatments/operations/surgeries. All this is done to maximize the profit of the hospitals. The cost at which it is done is completely neglected.
Hospitals have made doctors into blood sucking commodities, who take leverage of the poor understanding of patients of the medicine field.
There is not much the doctors can do either. If they raise their voice against such false practices, or do not agree to go ahead with them, they are being shown the door. It’s not possible for every doctor to set up his own clinic or hospital, so where is he/she supposed to go? Almost everywhere this is what the norm is.
And the patient feels that doctors are the main culprits. Of course they are a part of corruption, but it will be unfair to say that they are entirely responsible for it.
According to a report by The Times of India , a specialist doctor was quoted as saying, “Recently, a young doctor who joined our department told me, “Sir, every month there is a meeting with the CEO. He asks me questions because instead of having a 40% conversion rate for OPD-operative as per the target, my conversion rate is just 10-15%. (Conversion rate means out of all patients seen by the doctor, how many are advised to undergo surgery or procedures. Rational doctors try to keep this rate low, but profit-driven hospitals try to maximise number of surgeries and procedures, even if they are unnecessary). He tells me that such low conversion rate will not do, and that unless I increase it, I will have to leave the hospital.” This young doctor will certainly surrender one day. To survive professionally, he will start doing 20-25% of additional procedures that are not required by medical logic. What choice does he have?”… And each corporate hospital has such targets! There is no getting out of it.”
The private hospitals have tie ups with diagnostic centres, for performing several tests like ECG, MRI, CT scan, etc. More the number of patients referred to these centres, higher will be the commission for the hospitals.
The worst part about all this is that it’s almost impossible to regulate such activities. There is no body which can check if the tests and operations referred by the doctors are necessary or not. It’s very difficult to draw the line between what’s important and what’s not. The only way in which it can change is when morality takes the driver’s seat in the minds of the corporate giants who run 5 star hospitals.
So please don’t think that doctors are always the devils, their work life hangs on a knife edge, and sometimes there is just no way out.
This was about the ugly side of health care system in private hospitals. It’s not that only non government hospitals have a list of drawbacks, government health bodies too have loop holes, but more on that later.
