Demonetisation has hit the practice of giving doctors a commission for referring patients to a particular pathology laboratory or radiology outlet.
A certain percentage of money earned on diagnostic tests, medical check-ups and surgical procedures is handed over to doctors in return for their referral. The commission ranges from 15 per cent to 40 per cent. The practice is so widespread that newly opened diagnostic centres fear that they would have to shut shop if they do not pay up.
A radiologist, on condition of anonymity, said, “The practice is facing a crisis. People who give the commission have no cash now and doctors are refusing to accept the money in cash. Radiologists are planning to take advantage of the situation to put an end to the practice.”
He said, “The practice is so blatant that doctors threaten radiologists if they refuse to pay their share. Radiology centres fear they will lose business to their competitors if they don’t oblige. But after demonetisation, there is tremendous resistance from the doctors. They don’t want the commission in cash anymore.”
Dr. Prasad Kulkarni, executive member, Maharashtra Association of Practicing Pathologists and Microbiologists, said, “Attempts to stop the practice have been made earlier too. No association supports the unethical practice, but ground realities are different. It is good that doctors are discussing ways to end this practice.” Dr. Kulkarni also said that patients should also be wise enough to approach doctors who are ethical.
In 2014, there was heated discussion on the practice in the medical fraternity after a doctor filed a compliant with the Maharashtra Medical Council (MMC). Dr. H.S. Bawaskar from Mahad said he received a cheque of Rs. 1,200 as ‘professional services’ from NM Medical Centre in Pune for referring a patient there for a CT scan. Dr. Bawaskar said he had not referred any centre to his patient. The complaint highlighted how doctors were being lured into giving referrals to certain diagnostic centres.
Dr. Bawaskar’s complaint led the MMC to frame charges against NM Medical Centre for violating its code of ethics.
While big centres can afford to pay by cheque, smaller centres still make the payment in cash. “I wonder if such big diagnostic centres run by corporates can be put in check,” said Dr. Kulkarni.
