Sir, it is an open secret that laboratories, radiology clinics and other institutions offer doctors commissions and kickbacks for the act of referring a patient. The amount of commission is as high as 30- 50%. This deplorable practice encourages doctors to send patients for unnecessary tests, increases the cost of health care and reduces the quality of outcomes.
The Code of Ethics Regulations laid down by the Medical Council of India, forbids fee splitting or accepting of commissions by doctors. The code has, in recent, years been amended to make stricter rules against doctors receiving benefits in any form from drug and implant makers. However, rarely is action taken against offending doctors and institutions.
While there is a regulation that prohibits doctors from receiving commissions from other doctors or diagnostic laboratories, this regulation does not cover private hospitals. It is a common practice for institutions running high tech and high cost investigations and treatments to offer incentives to doctors who refer patients to them. They are free to pay doctors openly and even treat such payments as business expenses for income tax purposes.
The rampant corruption in Indian private health care has recently sparked a debate in the British Medical Journal as well. However, the MCI and the Ministry of Health have been slow in taking up the issue. I strongly urge the Government to take urgent steps to declare all commissions in health care illegal and create a strong deterrent against such practices.