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.

“Look at the crowd at the bar” my wife exclaimed.

My wife had accompanied me to an outstation academic conference for Radiologists. While I attended the conference hoping to learn any new trick, my wife, who is not a doctor, spent her day time shopping and visiting our relatives in that city. We were attending the post conference dinner that night and she had just witnessed the mad rush to bar counter as soon as it opened.

“Er, would you like a drink? I could use one myself.” I said.

“Excuse me Superman, but how are you going to beat that crowd and get us a drink?”

“Madam, could I have your permission to try?”

“Jao, Vijayee bhava ! ”

After a long time, I returned victorious with two half glasses of mediocre quality beverages, having spoilt my shirt in the process of elbowing and jostling through the crowd.

^Fifteen or twenty years ago - things at our hospital were not as bad. We had more people around, material was more easily available; the hospital was run by the administration and not by the unions and politicians as it probably is now. Even then, many of us strongly felt that there was a need to change the system of medical staffing so as to retain people. At that time, some of us spear-headed a movement -one of the many thus far- to allow full timers private practice.

All supported it - we swore by it. However, one man - one of the most respected in the campus - Sunil Pandya - the Chief of Neurosurgery - strongly opposed it. We adored "SKP"; he liked us a lot; he knew we were the future of KEM; he supported us in all our endeavors. But this time around it was a firm "NO".

“The Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act.”

“An Act to provide for the prohibition of sex selection, before or after conception, and for regulation of pre-natal diagnostic techniques for the purposes of detecting abnormalities or metabolic disorders or chromosomal abnormalities or certain congenital malformations or sex-linked disorders and for the prevention of their misuse for sex determination leading to female foeticide and for matters connected therewith or incidental thereto.”

* This article is for our Indian audiences.

Must be read by every Radiologist who performs Obstetric Ultrasound.