Are holier than thou the best ?
Dear Dr Ramakant Panda
I am the best endoscopist in the city. Dr D...., Dr S......, Dr M...... are all novices when compared to me. They cause complications, cheat patients, and do not know anything about their subject. Obviously these statements made to patients would be patently false and should be punishable. But Sir, if jousting of this kind is blatantly wrong , so also is claiming to be more honest than others in huge hoardings. When you claim not to give commissions to doctors you imply that all others give commission to doctors and hence you are the best. This is not only blatantly false propaganda but also unethical act as a medical professional which if only our medical associations / councils had some testosterone should be sufficient to debar you from practice of medicine for bringing the profession into disrepute.
However I come to a more important issue which needs urgent discussion. What is cheating ? Is charging Rs 3000 for a CT Scan and spending 500 towards direct business development (commission) cheating or is charging 6000 and spending 2000 in a different method of business development by putting hoardings in prominent places which cost 50000 per month cheating. After all why does Asian Heart Institute need its name on a bill board in the first place if not for business sourcing. To answer the question we need to first decide what is a rational, reasonable , fair price for a test / procedure / surgery which gives a reasonable earning to the doctor as well as does not fleece the patient keeping cost of equipment, infrastructure , human resource and utilities in mind.
The only reference on charges of medical procedures is the CGHS handbook and this is if anything the source of corruption in medical profession. Rates of procedures have been included which are at best laughable for want of a more appropriate word . Hospitals bill unnecessary procedures, medicines and lab investigations to sustain and to survive in-spite of delayed payments and commissions needed to be paid to release the bills raised . Hospitals need a department to deal with CGHS, ECHS, and other empanelments which is beyond the resources of a professional running a small establishment.
A video UGI Endoscope costs about 20 lacs and its life is about 3 years . Leaving aside the cost of his expertise a doctor needs to do 3-4 UGIE per day for 3 years 6 days per week to recover the cost at CGHS rates if one has to pay salaries in time, pay for infrastructure loans and utility bills. If no earning is to accrue to the doctor why should he work and be liable to pay compensation in crores for one accident.
What is needed is an authentic rate list which is reasonable to both the consumer as well as the service provider. Having written multiple times about this and uselessly looking up to big brother IMA to do something about it , MLAG has now decided to compile a genuine rate list which would be put forth for future use. I request all doctors / nursing homes, hospitals to kindly use the CHHS book and let MLAG know what is a genuine rate for all procedures given in the book and done by them. Central as well as various state Governments are keen on bringing out and enforcing rates of medical procedures. It is upto us to prepare a rate list which would be fair to all lest we crib later and find unethical solutions to low rates prescribed by the Government.
MLAG will advertise in National Newspapers soon to collect this data. Meanwhile I request all to kindly share your rates for various medical procedures as per the CGHS list of procedures along with the type of establishment graded as follows
1) Clinic only
2) Clinic & Day care centre
3) Nursing home/ Hospital without OT / labour Room
4) Nursing Home / Hospital with OT/ Labour Room but without 24 hr emergency
5) Nursing Home/ Hospital with OT / Labour Room and 24 hr emergency but no ICU
6) Nursing home with OT, 24 hr Emergency , ICU and Blood Bank
7) Teaching Hospital / Corporate Hospital with NABH / JCI Accredition
Kindly send your rates with the serial number of CGHS list to firstname.lastname@example.org . Please note that this is not a quotation for lowest rates acceptable but your genuine rates which you charge your normal patients or would charge your normal patients if CGHS etc was not on the scene.
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
1184, Sector 21 B Chandigarh
09316517176 , 9814013735
0172; 4633735, 2707935, 2706024, 5087794
For Contributions; "Medicos Legal Action Group" Ac No 499601010036479 IFSC code UBIN0549967 Union Bank Sector 35 C Chandigarh;