Ethical fee for doctors

Doctor’s consultation fee is always a controversial as some doctors feel that they charges very low and that too once a week or month so provide concession to patients and few doctors feel that in era of inflation it is very hard to suffice so they write Blood & other Fluid Pathology, Radiological, Endoscopic, Cardiac, Neurological, Orthopaedic etc. investigations. They want to get commission or cut provided by diagnostic centres. Many medicines companies provide doctors cut in form of cash or organising lunch/diner with cocktail or free registration fee or air tickets for medical conferences, seminars & meetings/get togethers for writing medicines including vaccines, diagnostic dyes, implants, stents and devices. Some doctors also get cutback by referring patients to other hospitals and doctors and many big & medium hospitals & doctors keep marketing team or agents to get patients from near by doctors in villages, town, cities, facorties and companies and even from foreign countries. Marketing team extensively market the treatment facilities, good records and about doctors in print and electornic media beside door to door visits to doctors and wallhoardings and posters. Even ECHS, CGHS, ESI, Pvt. Insurance Companies and TPA officials and doctors are bribed to get patients and get passed their inflated or normal bills. False insurance bills, fake medical certificates, Non-reporting of notifiable diseases, and medico legal cases to administrations and keeping unqualified doctors as homeopaths, ayurveds, unani in modern hospitals, keeping untrained staffs in OTs, labs, ICUs, refusing treatment in emergency and holding treatment of a patients or dead body for non payment is also practised by few. Many government doctors openly practice in private setups, send investigations in pvt labs and write costly medicines unavailable in government hospitals and use touts to shift patients from government hospitals to private clinics or hospitals and nursing homes. Most of patients feel that medical profession is a noble profession of service to mankind and as in ancient time doctors would not charge any thing from patients, so feel that doctors should charge minimum, should not charge high fee, repeated fee before 1 month. They feel Doctors receive cut back so write unnecessarily investigations and costly, unrequired medicines, admit patients in hospitals and nursing homes without any good reason and keep them for more days and some time do unrequired surgeries at least add such charges while making bills. Therefore, this noble profession is getting dirty and murckier in the eye of people. So, media, politicians, judges and bureaucrats who can nab and tap doctors are very much active to malign name, fame, reputation of doctors in society. So In West Bengal Assembly passed, such a derogatory and discriminating bill where doctors can be fined from 3 to10 lacs, may be jailed not for 2 yrs but also for 10 yrs with cancellation of registration. Hospitals can be fined from 10 lacs to 50 lacs, its administrators will be jailed and hospital will be closed if medical negligence found leading to suffering or death of a patients or over pricing bills by unnecessarily detening patients, unwanted or unrequired investigations, medicines by a New Commission of retired Judges & Bureaucrats. Commission will decide every price of any type of service fee, invstigations and medicines in hospitals and nursing homes. E Bills, prescriptions, day to day explanation of expense and treatment by a PRO team and fair price medicines shops must be practised. Commission acting as a court will give judgement within 6 months on a simple online application by any patients or relative aggrieved by treatment. It may implicate a criminal proceeding in court against doctors & hospitals. Many more states may follow it soon. So, it is high time that doctors and hospitals should introspect themselves. Medicine is regarded as the most noble of all professions. And, a doctor is accorded a status next to God. Hence, a doctor is duty bound to practice ethical medicine, which also includes ethical earning. We are professionals. We have a professional degree, which gives us a privilege to practice medicine. We are registered with a professional regulatory body. We follow a Code of Ethics as prescribed by the council. Our privileges to practice can be withdrawn in case of breach of the ethical code. Some major ethical and unethical practices are described by our councils are as follows: The consulting fee or billing process begins right at the time when the patient arrives at our clinic or hospital, with registration charges. Patient may also be billed for facilities provided in the clinic or hospital for once or multiple times. Charges for making patient summary, charges for the assistant/nursing staff/paramedical staff, charges for drugs and materials used, issuing a certificate, point of care investigations with no subsidy, dispensing medicines with no subsidy, administrative charges, charges for utility services etc. are other heads under which the patient can be charged are legal and ethical. Such Charges displayed or communicated to patient in advance,then may vary from doctor to doctor and hospitals to hospitals, and they are at liberty to keep their own charge of any service provided, investigations done. Accepting rebates and commission from diagnostic centers/laboratories and hospitals or fee splitting without involving any service for the referring, recommending implants/ stents/ medicines, vaccines or procuring of any patient is unethical. Any income generated out of such practices is unethical earning. Any advertising or marketing medical practice for earning, cuts, concessions, rebates, making false bills, issuing fake certificates, not giving first aid to accident, rape or severely injured or serious patients and unnecessary detention of a patient or a dead body, unreporting of notifiable diseases, medico legal cases and shifting patients from government to private hospitals are gross blunders. Only pharma or medical shops having separate license can sell the medicines or implants etc only. Let us all charge our legitimate fee and pass on the benefits of concessions on diagnostics etc. to the patients. Keep in mind the following: I have a right to charge rationally for my fee. I have a right to charge for every consultation, even the same day. I have a right to charge extra for emergency appointments, same day appointments and routine appointments. I have a right to charge extra for night visits. I have a right to charge extra for long consultations. I have a right to charge for accompanying a patient for diagnostics. I have a right to charge for briefing my senior specialist. I have a right to charge for visiting my patients when they are admitted in a hospital under a specialist. I have a right to charge for legal certificates. I have a right to charge for telephonic consultation. I have a right to charge for reviewing reports. I have a right to charge for only giving opinions on reports.

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