Unethical Practices in Pvt Hospitals - Addl Inputs
Below are the key issues, root causes and solutions related to unethical practices in private hospitals as identified by you. Kindly review and if you have specific additional inputs, please share.
The objective here would be to take this up with the Government and Regulators so key actions can be taken to address them.
Transparency International India
Unethical Practices in Private Hospitals - Solutions
1. Doctor’s compensation and incentives in a hospital has to be completely de-linked from revenue they bring to the hospital
2. Any hospital found to be asking patients to take unnecessary tests should be slapped with a large fine
3. The Government should decide the maximum rate at which a private hospital could conduct tests like MRI, CT scan etc.
4. Laws should be created under which private hospitals suggesting non-required procedures to patients could be tried
5. Strict laws should also be made to prevent hospitals from misleading and overcharging customers
6. Ethical and moral refresher courses should be conducted for doctors every year
7. Hospitals should try administer generic medicines to as much extent as possible
8. An independent or Government agency should be appointed to rate all the hospitals in India on ethics/integrity
9. Hospitals should be asked to file a report every year where they would justify the amount that they charge for different procedures/tests
10. Criteria needs to be laid out that clearly defines what are the minimum requirements to open and run a hospital
11. Cost of operations and treatments should be fixed in a range depending on the type of hospitals - tertiary, secondary or primary hospitals
12. To get certified they should have met certain criteria that is specified by the Government
13. All hospitals must be subject to authorised external audits and any irregularities and unethical practices must be made punishable.
Unethical practices in Pvt Hospitals - Root Causes
1. Private hospitals are run like businesses
2. Heads of departments are given revenue targets to achieve
3. The remuneration of the doctor is linked to the amount of revenue he makes for the hospital
4. Private hospitals have better and latest machinery which results in higher test rates
5. Hospitals take insured patients as an opportunity to generate more revenue
6. Lack of strict laws against hospitals for misleading/overcharging the customers
7. Cash payment is preferred to save on taxes
8. Branded medicines are prescribed instead of generic ones as the doctors and hospitals earn commission from these pharma companies
9. Private hospitals look at EWS patients as an expense and hence do not admit them easily
10. Most uneducated patients quietly follow everything a Doctor says due to lack of awareness
Unethical Practices in Pvt Hospitals – Issues
1. Patients are asked to take unnecessary tests
2. Rate of tests like MRI, CT scan etc. are way higher in private hospitals than outside
3. Many hospitals straight away suggest surgeries in case where it might not immediately be needed
4. If the patient has insurance, the hospitals keep them admitted for a longer duration of time and bills are inflated
5. Expensive steroid medicines are given
6. Patients are kept on ventilators even if there is no chance of recovery
7. Room rates in private hospitals are really high
8. Private clinic/hospital encourage to pay bills in cash and also give forged bill
9. In place of generic medicines, branded costlier medicines are recommended
10. People with health cards, medical insurances extra also lured into unnecessary treatments, procedures and surgeries
11. EWS patients are not given admissions easily. more
The objective here would be to take this up with the Government and Regulators so key actions can be taken to address them.
Transparency International India
Unethical Practices in Private Hospitals - Solutions
1. Doctor’s compensation and incentives in a hospital has to be completely de-linked from revenue they bring to the hospital
2. Any hospital found to be asking patients to take unnecessary tests should be slapped with a large fine
3. The Government should decide the maximum rate at which a private hospital could conduct tests like MRI, CT scan etc.
4. Laws should be created under which private hospitals suggesting non-required procedures to patients could be tried
5. Strict laws should also be made to prevent hospitals from misleading and overcharging customers
6. Ethical and moral refresher courses should be conducted for doctors every year
7. Hospitals should try administer generic medicines to as much extent as possible
8. An independent or Government agency should be appointed to rate all the hospitals in India on ethics/integrity
9. Hospitals should be asked to file a report every year where they would justify the amount that they charge for different procedures/tests
10. Criteria needs to be laid out that clearly defines what are the minimum requirements to open and run a hospital
11. Cost of operations and treatments should be fixed in a range depending on the type of hospitals - tertiary, secondary or primary hospitals
12. To get certified they should have met certain criteria that is specified by the Government
13. All hospitals must be subject to authorised external audits and any irregularities and unethical practices must be made punishable.
Unethical practices in Pvt Hospitals - Root Causes
1. Private hospitals are run like businesses
2. Heads of departments are given revenue targets to achieve
3. The remuneration of the doctor is linked to the amount of revenue he makes for the hospital
4. Private hospitals have better and latest machinery which results in higher test rates
5. Hospitals take insured patients as an opportunity to generate more revenue
6. Lack of strict laws against hospitals for misleading/overcharging the customers
7. Cash payment is preferred to save on taxes
8. Branded medicines are prescribed instead of generic ones as the doctors and hospitals earn commission from these pharma companies
9. Private hospitals look at EWS patients as an expense and hence do not admit them easily
10. Most uneducated patients quietly follow everything a Doctor says due to lack of awareness
Unethical Practices in Pvt Hospitals – Issues
1. Patients are asked to take unnecessary tests
2. Rate of tests like MRI, CT scan etc. are way higher in private hospitals than outside
3. Many hospitals straight away suggest surgeries in case where it might not immediately be needed
4. If the patient has insurance, the hospitals keep them admitted for a longer duration of time and bills are inflated
5. Expensive steroid medicines are given
6. Patients are kept on ventilators even if there is no chance of recovery
7. Room rates in private hospitals are really high
8. Private clinic/hospital encourage to pay bills in cash and also give forged bill
9. In place of generic medicines, branded costlier medicines are recommended
10. People with health cards, medical insurances extra also lured into unnecessary treatments, procedures and surgeries
11. EWS patients are not given admissions easily. more
Viewed by 2421
View all 61 comments Below 61 comments
How do we come out of the procedural delays in legal cases in our courts across the country. May be such a process of delays breeds corruption. Litigants are suffering particularly the poor people. The government shall have to come out with a legislation for limiting the time period of all such pending cases in various courts . Legal profession needs to be streamlined and some index of cost fixed for cases in respect of their nature and urgency so that a common man can afford the cost of litigation easily. more
Jan 08
Concentrating only on pvt sector and neglecting govt sector will not solve the problem Most patients in India need basic and primary care. We are seeing only the urban side and tertiary care hospitals. Had the govt realized its mistake and taken corrective action.the things would not have come to such a state. Making laws and trying to regualte will need to inspector Raj and one more layer of corruption will be added. Time tested method - was stregthen small clinics run by family practionoers and small nursing home. MORE AND MORE CASES ARE REGISTERED AGAINST doctors negligence. Consumer courts are trying to find a negligence on petty things - Like every delivery is to be attended by a paediatrician. Is is possible in a village where in Primary heath centre there is only one doctor. 2. The doctors do not need a battery of tests to diagnose - but are being forced to do so - to save themesleves in courts. Courts do not accept the Clinical judgement but ask for proof. Doctor can diagnose Pneumonia without an X-Ray that is what happens in a village - but if the patient deteriorates and does not respond to treatment - the doctor has to face the negligence complaints. The job of Govt is to provide primay health care - and to not make so many AIIMS which conusme a lion;s share of the GDP . Districs hospitals are ill equipped . If the money is spent on primary health . Poor people will not rush to corporate hospitals . Let the rich and affllunet go there who in anywat prefer tea of five star hotel. more
Dec 14
First of all the government should ensure that the tuition fee in private medical colleges is drastically reduced with immediate effect. There is no justification in charging more than a crore of rupees for a five year course. Then again huge amount has to be spent for acquiring specialisation. If a few crore of rupees require to be spent to become a specialised doctor, it would be foolishness to expect him/her engaged in social works. It is but natural that his/her priority would be to recover the money spent on his education along with interest rather than extending his helping hands to others & the needy and there would be nothing wrong to have such attitude. This issue must be resolved first. Majority of the private hospitals renowned for specialisation in different ailments are standing on land provided by the government on concessional prices. What prevent them to ensure that these hospitals function ethically and on the principle of humanity with provisions for huge penalty including withdrawal of licences and cancellation of land allotment? Who will decide as to whether the hospitals'/doctors' recommended tests are required or not? As a matter of fact, on hospitalisation, a patient and his family members psychologically break down (with some exceptions) and become preys of the hospitals and the doctors losing all courage to ask any question and the hospitals & the doctors encash this situation in their favour. It is the government to find out a workable solution to such situations. It is pathetic that the members of the public need to suggest the government to initiate proactive action to ensure that the private hospitals and the doctors refrain from duping the patients. Is not the government aware of the happenings in these hospitals all over the country? If yes, what prevents them in initiating necessary measures to bring transparency in medical services? Despite having good doctors in government hospitals, people do not prefer to go there because of mismanagement, dirtiness, political interference and indifferent & non-co-operative attitude of the staff including the doctors. All governments including the state governments must pay their pointed attention towards their hospitals to make them disciplined & free of political interference, ensure dutifulness & honesty in staff and doctors as well as clean, so that these hospitals become first choice of people, which will help to end the monopoly of the private hospitals and doctors and teach them to behave. more
Dec 12
This is all milli-bhagat (knowingly unknown to anti-corruption departments). Who will bail the cat ??? more
Dec 08
What comes to mind is, when the cost of medical expenses is very very high, at what stage should the patient/attendants take a "Second Opinion" - before or after the tests prescribed. more
Dec 08
