iRADiX

The practice of fee-sharing or cut practice is regularly condemned by the medical fraternity and general public. Patients are waking up to this reality, making it one of the major reasons of declining doctor-patient relationship. Almost every discussion about cut practice results in loud cries of moral indignation. Despite this, such practices flourish and have now enveloped much of the modern medical practice.

Forms of Cut Practice

We radiologists tend to think that we are the most affected by this ‘affliction’ but it is much more diffuse and pervasive in the medical field. It takes many forms (1):

• Giving a share of fees to the referring doctor.
• Referring patients for unnecessary consultations or tests to ensure a kickback from the consultant or laboratory.
• Giving expensive gifts periodically to the referring doctor.
• Appointing junior specialists to a super specialty hospital so that procedural work is always referred by them to you.
• Unnecessary admissions in nursing homes/hospitals.
• Sponsoring of a conference or payment of travel expenses by a company in return for the use of its equipment or prescription of its drugs.

Hippocratic Oath has lost relevance due to ever changing religious, political and social milieu. I faintly remember a line 'you can not advertise yourself, though you can advertise your hospital'. Taking into account a large number of physicians doesn't it sound absurd? In your daily life and during your practice have you not been asked by the public or a fellow doctor as to which hospital or doctor would be better for a particular patient. Do we not enquire where to send a patient for X-Ray, C.T. or MRI and do we not know whose report is reliable and whenever the report appears unsatisfactory do we not look for the name of the doctor signing it. Some institutions have developed a name for themselves, like AIIMS in Delhi, KEM, TATA memorial hospitals in Mumbai to name just a few. These hospitals are very large many with over 2000 beds and a large number of satisfied patients go home talking good about them. These hospitals need no further advertisement.