Eminent doctors from across India support Asian Heart’s anti cut-practice crusade

Mumbai: At the city’s revered cardiac speciality hospital Asian Heart Institute, the needle moved forward on the discussion against the cut practice. The gathering emphasised the fact that if cut practice stopped, expenses related to medical stopped, would go down by 20-25%.

Dr.Vijay DSilva, medical director of Asian Heart Institute opened the press conference, clearly indicating that in the span of the 40 years, cut practice has moved from the fringe of medical practice to its core, with many young doctors being forced to practice, even though they didn't want to. He then asked all the participating doctors to express their views.

The attendees in person included Dr. Gautam Sen, Chairman and co-founder of HealthSpring and Dr. Vikrant Desai, Vice-President IMA Mira Bhayander, along with Dr. Ramakanta Panda and Dr.Vijay D’Silva of Asian Heart Institute and Tamara Zweck (PT) of 206 Optimal Movement.

PadmaBhushan Dr K Srinath Reddy - president PHFI & ex president world heart federation, Padmashri Dr Samiran Nundy - editor of the Indian Journal of Medical Ethics, Padma Shri, Padma Bhushan, Dr Devi Shetty, Chairman and Founder of Narayana Health, Padmashri Dr G N Rao - founder & chairman L V Prasad eye institute, Padmashri Dr Soma Raju - Founder chairman -Care hospitals and Dr.Himmatrao Bawaskar of Bawaskar Hospitals Mahad sent in video and audio messages to support the cause.

Here’s what all of them said.

Dr Samiran Nundy

I congratulate Asian Heart Institute for setting up this initiative. It is a much needed national dialogue; as this is one of the great problems of Indian healthcare.

Early next year, we are coming out with a book “Healers or Predators”, to be published by Oxford University Press, with about 40 chapters; which speaks about this issue. One must note that cut practice is not confined to India. It exists everywhere, and could be worse in other countries as well. However, these countries have strict monitoring bodies that dole out tough punishment for wrongdoing; and that is missing in India.

​Dr. Bhupathiraju Somaraju

We are thankful to Asian Heart Institute for this initiative. Kickbacks are just one of the multiple things that need attention.

However, we have to look at this not from a doctors point of view alone, but also from a hospital’s point of view. The deeper issue is that it takes a doctor 15 years to start earning, whereas CAs and engineers can earn in 3/4 years time. The inequity within healthcare is enormous. There are so many healthcare technicians who are in poor shape and cannot even afford to educate their children. Look at it this way- the average voter is paid money to vote- so who is guilty, the giver or the taker? Ethics and value systems should be taught in medical schools.

Dr Gullapalli Nageswara Rao,

Cut practice is a fundamental flaw in the medical profession; and it is not easy to root it out. I see the solution to this deep rooted problem in three ways

• what can be done immediately
• what can be done in the intermediate
• what can be done in the long term.

The long term solution is to start at the education level- medical students should routinely hear from people who inspire them. Successful doctors with money get lionised; but we need to stand against this by projecting and highlighting those doctors who uphold ethics in medicine. There is a difference between doing”well” and doing “wrong”.

In the intermediate, a core group must travel the length and breadth of the country- and speak to the younger doctors to follow the ethical path. What if the government passes some draconian law that patients going to private doctors must take a second opinion with Govt doctors! Its better that we police ourselves rather than have the government resort to extreme outcomes.

In the immediate term, we must talk to the management of hospitals and convince them to not indulge in cut practice. The government has to take action against those indulging in cut practice for this menace to stop.
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Dr. K Srinath Reddy

"The initiative to de-normalise and eliminate cut practice in the medical profession is very welcome and long overdue. The ethical foundations of this profession need to be reinforced by the professionals coming together to cleanse it of distortions that have crept in. This will only happen when we speak up. Asian Heart Institute meeds to be congratulated for opening the door to honest introspection and sincere self correction by the medical profession.”

​Dr. Devi Shetty

Medicine is an honourable profession. Unfortunately, a few hospitals are indulging in the unethical practice of accepting or offering kickbacks for patient referrals. This is a very sad development; which should be resisted by all medical professionals. My sincere request to every hospital big and small, and every practising doctor is to refrain from encouraging incentive based practices and restore the integrity of our profession.

​Dr. Vikrant Desai, Vice-President IMA Mira Bhayander

We are with Asian Heart and Dr.Panda in this crusade. It is very necessary to win back the trust of the patients; which has been eroded over the last few decades.

​Dr.Himmatrao Bawaskar

I’m very happy that Dr.Panda is taking steps to curtail the practice of commission among doctors. This is a cancerous disease and Ive been fighting since 2006- when I received a 500/- note as kickback for referring a patient. I complained but nothing happened. Later on a radiologist gave me a cheque of 1200/- and I complained to the Maharashtra Medical Council- they issued a memo and stay order.

This is important- morality and ethical practice has to be learnt at home and in school. We must learn from the heart. Stopping commission; reducing necessary investigations is necessary. We may not get 100% success- but at least we will get 80% success in curtailing this.

​Tamara Zweck (PT)

When I came to India, I was told by many people that unless I indulge in some form of referral kickbacks, I wouldn't be able to set up a sustainable practice. However, I have succeeded with my ethics intact and I think, if I can do it, so can the others.

​SUMMING UP

Dr.Ramakanta Panda of Asian Heart thanked all the eminent doctors for their support. He said that its important to keep the anti-cut practice discussion in the public domain; so that the argument builds some momentum. He added that a core committee comprising all the eminent doctors who participated in the press conference and some more doctors will be taking up the matter at the centre and state level; to push for reform.

Many doctors have joined hands against the menace of cut-practice, and there was a consensus that doctors and hospitals need to recommend changes in policy , and their enforcement to promote the ethical medical practice.