New Delhi: Alleging referral incentives and “cut-money arrangements” between doctors and diagnostic centres in the country, Bharatiya Janata Party MP Raghav Chadha Monday called for a stop to the practice, saying patients were being charged with medical bills inflated 15-20 percent.
Speaking in the Rajya Sabha, Raghav Chadha underlined that such medical referral commissions, often referred to as “cut-practice” arrangements, are strictly illegal and unethical, and went on to give an example. “Suppose the doctor prescribes you an MRI (Magnetic Resonance Imaging) test that costs a total of Rs 9,000. Out of this, an average of Rs 3,000 will go directly into the pockets of doctors referring him to the diagnostic centre,” Chadha said.
Significantly, the National Medical Commission bars doctors from accepting any gifts, commissions, or financial incentives for referring patients, tests, or procedures to other specialists or diagnostic labs.
“On an average, Rs 3,000 is going directly into the pockets of doctors. This is called a referral commission,” Chadha said, adding that these commissions are ultimately recovered from patients by embedding them into their diagnostic bills, inflating them 15 to 20 percent.
“Set commission rates, dedicated agents and a parallel incentive economy” are all in place to facilitate the process, Chadha said, adding that account books of diagnostic centres refer to this as marketing expense.
Raghav Chadha further alleged that some diagnostic centres lure doctors with foreign trips and other incentives in exchange for patient referrals and called for stricter enforcement of the medical profession’s code of ethics.
“We consider doctors to be gods in our culture. When one is on their death bed, the doctors are the last ray of hope, but some doctors are stuck in these arrangements,” Chaddha said, adding that the practice is especially prevalent in tier-2 and tier-3 cities.
Calling for an end to the practice, the BJP MP also said patients can watch out for certain red flags such as doctors getting irritated or upset when a patient refuses to go to a particular diagnostic centre, or prefers another.
Clarifying that he is not against doctors but against the practice of subjecting patients to unnecessary tests and cut-money arrangements which were now establishing an informal economy.
Violation of medical ethics guidelines
Chadha also referred to the National Medical Commission (NMC) Code of Medical Ethics Regulations, 2002, which, under Regulation 6.4 strictly bans doctors from giving, receiving, or offering any gift, gratuity, commission, or bonus for referring patients, tests, or treatments. Formerly these regulations were known as the Medical Council of India Regulations, 2000.
Apart from this, in 2023, the NMC had banned this “referral commission”, while saying that the punishment for the same should be at least 1-3 months of suspension, Chadha said in Parliament, adding that the same could also be construed as cheating and a violation of consumer protection laws.
The ethical code framed by the former Medical Council of India, whose regulatory functions have since been taken over by the NMC, expressly prohibited physicians from giving, soliciting or accepting any “gift, gratuity, commission or bonus” in return for referring or recommending patients for treatment.
This prohibition extends to referrals of diagnostic samples or specimens to laboratories. Violations can invite disciplinary proceedings by the appropriate medical council, which may impose penalties ranging from suspension to removal from the medical register, depending on the findings of an inquiry.
(Edited by Viny Mishra)
If government is keen on tackling this, they can look into bank accounts of a few suspended doctors to find out the source of money coming in.
It’s easy but not in PM’s interest at present! He has bigger problems to deal with.
Everyone gets a feeling that Modi’s currency is falling and Gen Z are anti- Modi.