“It’s a win-win for all,” says Mohini (name changed) the owner of a sample collection and testing centre at Rohini Sector-23 which is currently advertising a “limited-period promotional scheme” offering 80+ full body tests, including free tests for vitamin D and B, for an all-inclusive price of ₹999.
“A vitamin D test alone costs ₹800,” she says, adding that the scheme, which they come out with depending on the sales at that time of the year, is being offered for a short period only to advertise their centre which has been running for five years.
“We are able to sustain this because of the bulk orders that we get. We get good business and the patients get a good price. No problem for anyone,” she says.
The Delhi Medical Council, however, begs to differ.
“There is a huge problem,” says Dr. Girish Tyagi, registrar of the DMC.
“It is illegal to begin with. The Medical Council of India’s Code of Medical Ethics clearly states that these kinds of schemes, offers and promotional stunts are not allowed. Sadly the violation is rampant despite orders and action being taken against the erring healthcare establishments and individuals.”
Illegal practice
Solicitation of patients directly or indirectly by medical professionals is unethical under the MCI rules and regulations.
About rebates and commission, the law says that a physician shall not give, solicit, or receive, nor shall he offer to give, solicit or receive any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment.
Also, a physician shall not directly or indirectly participate in or be a party to an act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.
This applies with equal force to the referring, recommending or procuring by a physician or any person, specimen or material for diagnostic purposes or other study/work.
Rampant violations
The law, however, has not deterred those in the business from soliciting patients. Currently, multiple discounts are being offered by hospitals/health centres and labs running in the city.
There are IVF treatment centres offering up to 50% discount while other health centres are offering cashback, price reduction on loyalty points and discounts on referring a friend, among other schemes.
Besides this, there are advertisements of doctors in private hospitals or individuals who are regularly featured in advertisements claiming to cure infertility, diabetes, obesity, skin conditions and other such health issues.
“Again none of this is allowed. We have been cracking down on these healthcare centres and individuals routinely,” says Dr. Tygai.
Those putting out such advertisements say this is “just business”. “With so many healthcare facilities across the city, it is important that people know what we are offering. We are spreading awareness about the procedure and costs,” said Rahul (name changed) who works with a well-known medical company offering home care, testing and medical equipment.
High treatment cost
With out of pocket treatment costs in India spiralling to a 70% high, no consumer is complaining about the free treats or discounted examination or treatment costs. “I have been using a private online medical health provider for lab tests and getting medicines for my father who is suffering from compromised kidney function. This private provider gives us loyalty discounts, cash benefits on bulk testing and purchase of medicines. Even regular pharmacies are now offering loyalty points and discounts. It’s the customer who is getting a good price at the end of the day. Why should we complain,” says Marian Martin (name changed) from Pandara Road.
According to research papers published recently, the morbidities cost per illness episode has inevitably increased in the last decade in India. The increase in life expectancy, demographic change of more aged population, coupled with chronic disease, will increase the morbidity and health expenditure in the future.
With this as the background, Dr. Anil Bansal, a member of the Delhi Medical Association and also part of the Delhi anti-quackery team, says that “it is this helplessness of the consumers that keeps the market going”.
“Advertisements by large hospitals/labs/private practitioners are illegal but it is happening through traditional form of ads, social media, social groups, promotional phone calls and even pamphlets. Private hospitals are seen advertising about ‘famous’ doctors or technology or health packages. Doctors and hospitals announcing successful surgeries, procedures etc, though informative, are also surrogate advertising,” he explains.
What action is taken against the erring doctors, health centres? “When a doctor is found violating the rules, initially a warning is issued. If he/she does not fall in line, it is followed by temporary and later permanent removal of the doctor’s name from DMC registration, which is mandatory to work in the city,” says Dr. Tyagi.
“In case of violation by labs etc, since they are not registered with us, we alert/write to the Delhi government’s health department to take appropriate action under the law,” he adds.
Not limited to Delhi, the violation has been taken note of in other parts of the country too. Recently, the Madhya Pradesh Medical Council issued warning notices to nearly 50 prominent doctors in the city for advertising and promoting their skills; in 2016, Tamil Nadu Medical Council took a resolution warning doctors against advertising online; last year, the Maharashtra Medical Council issued show-cause notices to 40 doctors for putting up advertisements on print, TV and social media.Treatment on saleAll kinds of schemes, offers and promotional stunts by medical professionals and health centres are unethical under the MCI rules.
