Feature Corruption in Medicine

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

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4312 (Published 03 September 2015) Cite this as: BMJ 2015;351:h4312
  1. Meera Kay, journalist, Bangalore
  1. meerakay{at}ymail.com

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

“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 …

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