Saturday, September 5, 2015

The unethical revenue targets that India’s corporate hospitals set their doctors

What can be done about financial targets for doctors working in profit driven hospitals that lead to expensive but unnecessary tests and surgery that also come with risk of harm, asks Meera Kay 
Meera Kay journalist, Bangalore

 “For seven years I had to bear the burden of doing unnecessary investigations and procedures, including angioplasty, under pressure from the management of the hospital,” Gautam Mistry, a cardiologist in Kolkata, told The BMJ.
What Mistry is describing is one of the best kept secrets of India’s private healthcare sector—consultants hired by private hospitals have to meet targets for generating revenue by overprescribing diagnostic tests and avoidable surgeries.

No data exist on the prevalence of such targets, and Mistry did not disclose details of what targets he had been set.

 “Significant numbers of patients must be advised to be admitted for surgery or medical procedures that bring in real financial profit for the hospital,” explained Kunal Saha, adjunct professor and HIV/AIDS consultant in Ohio, United States, and president of People for Better Treatment, a non-governmental organisation that promotes corruption free healthcare in India.

 Unnecessary risk, additional cost “Needless surgery, even simple procedures like tonsillectomy or appendectomy, may cause unexpected hazards for the patient,” he said.

Unnecessary surgery not only comes with the risk of harm but also burdens patients and their families financially, often directly. “In the absence of any effective medical insurance system, most ordinary patients in India are forced to pay the hefty hospital bills out of their own pockets,” Saha said.

Such unethical practices are widely known about in medical circles but public discourse has been lacking. “Doctors who face pressure from hospital management to overprescribe surgeries or investigations fear for their livelihood,” Mistry told The BMJ. “They also need to practise for a certain number of years, and by complaining they would be jeopardising their career.”
Conscience takes a back seat

Support for Advocacy and Training to Health Initiatives (SATHI), a non-governmental organisation based in Pune, documented the problem for the first time in its recent report, Voices of Conscience from the Medical Profession.
The report contains interviews that the gynaecologist Arun Gadre held with 78 doctors throughout India. 

1 More than half of India’s hospital beds are in the private sector.

2 Gadre, an associate coordinator at SATHI, told The BMJ that India has seen a rise in multispecialty hospitals. “Some are run by corporates but most are run by business minded professionals,” he said. “Their main aim is to generate revenue and profits for their investors. In the race to earn higher profits, conscience takes a back seat, and doctors are encouraged to indulge in unethical practice.” Sharing the feedback of a surgeon from a metropolitan city, Gadre recounted, “Corporate hospitals are not content unless there is some procedure or operation done related to each bed in the hospital.”
Performance targets raise efficiency.

Some doctors disagree about the ubiquity of financial targets for doctors, including Devi Shetty, cardiac surgeon and chairman of the Narayana Health Group, which runs 32 hospitals for profit in 20 locations in India and abroad. 
“We often hear about revenue targets for doctors in private hospitals; I know it is a very rare phenomenon,” he told The BMJ. He said that Narayana’s hospitals do not set financial targets for doctors but do set performance targets to raise efficiency. “Hospitals like ours will definitely expect doctors to work long hours to serve the needs of thousands of outpatients. We can’t afford to have doctors spending more than an hour with a single patient. But setting financial goals for a doctor is not a common practice in India,” he said

Regulating doctors’ practice

In taking the Hippocratic oath every doctor pledges to uphold ethical standards. Yet allegations such as these indicate an inability of some doctors to regulate themselves.

The Medical Council of India (MCI) is responsible for institutional regulation of medical services. But its reputation is in tatters—its inability to collect data on alleged medical negligence and general failure to bring prosecutions do not instill confidence.

3 The cry for transparency at all levels of the MCI is growing ever louder in India.

4 Saha said that the MCI had unequivocal and stringent provisions against unethical medical practice by registered physicians, which clearly encompass the deliberate referral for unnecessary medical or surgical procedures. But, “such medical laws are hardly enforced by the Machiavellian MCI and other state medical councils that have always worked only to maintain the hitherto ‘untouchable’ status of the Indian medical community,” he said.

“A radical change in the structure and functioning of the MCI is the need of the hour,” Gadre told The BMJ. “The elected members are all doctors, which could result in a biased outlook.” He said that the Clinical Establishments (Registration and Regulation) Act 2010, which is not uniformly implemented in India, should be enforced by the government, because it has provisions to check the prescription of surgeries and investigation. He said that all practice should be evidence based, with standard treatment guidelines.

People for Better Treatment and SATHI are among a handful of organisations in India voicing concerns over revenue targets for doctors at corporate hospitals. People for Better Treatment is trying to tackle unethical practice by recourse to the law, through public interest litigation in the Supreme Court of India, for example, to allow the public to challenge complaints that the MCI drops. The Society for Less Investigative Medicine, which was initiated last year by cardiologists at the All India Institute of Medical Sciences in Delhi, hopes to raise awareness of evidence based recommendations for medical care.6 7

Second opinions India now has several internet portals that offer a second medical opinion, such as mediangels.com and apkadoctor.com, which run on the premise that surgical interventions in India are overprescribed. One report showed that second opinions about surgery reversed the recommendation in 44% of 12 500 patients.

However, these companies are for-profit ventures and charge patients for second opinion consultations. “Honest and well minded doctors must stand up and speak out loud against their corrupt medical colleagues,” said Saha. The public “must also raise their voices to mount pressure to force the inept government to take exemplary action against the unprincipled doctors and avaricious private hospitals,” he said.  

The BMJ contacted the MCI and the Association of Healthcare Providers (India), the trade body for private hospitals, but had not received responses by the time this article was published.

Competing interests:
I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.
Do you have a story to tell about how financial targets have affected your practice as a doctor? Let us know by sending a rapid response to this article or by emailing rhurley@bmj.com in confidence.
Provenance and peer review:
Commissioned; not externally peer reviewed.

1 Gadre A. India’s private healthcare sector treats patients as revenue generators. BMJ 2015;350:h826. 

2 Edacherian S. Financial growth of private players in Indian hospital sector. Frost and Sullivan. 14 Feb 2014. www.frost.com/sublib/display-market-insight.do?id=289119345.

3 Nagarajan R. Clean slate for doctors on medical negligence. Times of India 2013 Dec 15. http://timesofindia.indiatimes.com/india/Clean-slate-for-doctors-on-medical-negligence/ articleshow/27394151.cms.

4 Pandya SK. The Medical Council of India: need for total overhaul. Indian J Med Ethics 2014;11:68-71.

5 Francis PA. States and clinical establishments. Pharmabiz 2015 Apr 29. www.pharmabiz. com/ArticleDetails.aspx?aid=87988&sid=3.

6 Travasso C. Indian cardiologists plan campaign to reduce unnecessary investigations. BMJ 2014;349:g4740.

7 Nagarajan R. Doctors across India join hands to stop practice of unwanted tests. Times of India 2015 May 17. http://timesofindia.indiatimes.com/india/Doctors-across-India-joinhands-to-stop-practice-of-unwanted-tests/articleshow/47313607.cms.


8 Iyer M. 44% advised unnecessary surgery: 2nd opinion-givers. Times of India 2015 Jan 4. http://timesofindia.indiatimes.com/india/44-advised-unnecessary-surgery-2nd-opiniongivers/articleshow/45746903.cms.

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