Doctors fees

Doctors fees
Are we working for peanuts ?*
Dear Colleagues,
It is a great opportunity and responsibility to become a doctor.
Recently I had an opportunity to visit Hon. Supreme court of India for a public interest litigation. I paid 1.25 lakhs for filing the case and 2.5 lakh to the senior counsel to appear for us.The case was filed as SLP.
During this time as a petitioner I had an opportunity to see how the court functions. Hardly the Hon. Judges listen to the cases for 30 seconds and ask one or two questions and then accept or reject the cases.
For this 2 to 3 minutes court procedure, a client spends approximately 5 to 10 lakhs. Whatever may be the result the clients have to accept it. I do admit, the consels or advocates have to study the case thoroughly before the appearances.
Today a patients relative came to me complaining that “one senior doctor has charged ₹ 500 as consultation, nursing plus iv administation charges and a short hospital stay of 4 hours, total 4000 Rs”. He said the charges are too much. “We are his regular patients. We should get concession in fees”.
I narrated to him my supreme court story and told how the advocates charge us.
I asked him is there any thing more important than human life? The concerned senior doctor who had given you relief should have charged his personal fees in the tune of 5,000 to 10,000 Rs per consultation.
I have seen many young doctors displaying on big hoarding that they will do C Section in 20 thousand including medications, anaesthetist and hospital stay.They will do hernia repair in 15,000 and so on.
As Immediate past President of IMA Bhandara, I have visited many times in our NP Bhandara, requesting the authorities to reduce the fire NOC charges, I have requested various agencies to reduce fire audit charges.No one gave us any relief. Running a clinical establishment requires so many permissions and charges. Pollution control board, Fire NOC, fire audit, lift certificates, corporation taxes, electric bill, telephone bills, Banks EMI on equipments and establishments, salaries, Nursing home registration renewal charges, repair and maintenance of equipments, AMCs and so on.The list is exhaustive. Running a hospital is like running a circus. At the end if you calculate, the doctors get peanuts!
Many times to get cheap popularity, we reduce or subsidise our charges. We think our fellow colleagues as our competitors. Our this attitude is exploited by insurance companies.
On this 75th Independence day of our country, let us pledge to make all our colleagues financially independent and wise!
I have seen a peculiar practice among the lawyers. A lawyer after 15 to 20 years of practice is elevated as a senior counsel. His junior colleagues canvass for him and refer cases to him. They quote substantial charges to elevate the status of their senior colleagues.The senior advocates give his junior counsel all the right to draft the cases and do official work.This is a win win situation for all of them. One thing I have observed in lawyers community is that they prefer to accept their fees in cash.
The purpose of this writeup is that we have to become financially wise to establish a support system for our own colleagues.
I know many of us who are earning a lot may not like the above view points, but friends life is very uncertain. At least on this 75th Independence day please take a pledge that I will not spoil the practice of my colleagues by working for peanuts.
Long live IMA.
Dr Nitin Turaskar
Immediate Past President IMA Bhandara

IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 5 Ser.15 (May. 2020), PP 57-60 http://www.iosrjournals.org
Consultation fees of Indian doctors: the myth demystified
Sumangala Bhat K
Dextrose Technologies Pvt Ltd., #124, 2nd Floor, Kengeri Satellite Town, Bangalore -560060
Abstract
Background: Medical expenses are an inevitable part of human life and often perceived seriously by all walks of life. With emerging epidemics and other diseases, this takes the center stage, in terms of quality, the expense involved, and risk parameters. In India there is a popular belief that Indian doctors charge high consultation fees. The present study aims to analyze this assumption with facts and figures, considering allopathy practitioners in India.
Methods: The practicing doctors have been categorized into 3 strata such as general practitioners (MBBS), specialists(MD/MS) and subspecialists (MD/MS with additional qualifications).A survey on the consultation fees charged by individual practitioners at selected Indian cities and BRICS countries has been made. Further, mean values of the consultation fees of each category of the doctors are compared with ordinary saloons, 5 star saloons, SPAs and the price of popular burger brands and Coca-Cola across the selected cities in India and BIRCS countries.
Results: The comparison of the consultation fees of Indian doctors with their counterparts in other BRICS countries has confirmed lowest fees being charged by Indian doctors. On comparison, hair-cut charges for men at ordinary saloons were found to be on par to 48-66% of the consultation fees of different types of doctors whereas the hair-cut charges at 5star saloons and SPAs surpassed doctors’ consultation fees up to levels of 130% and 201% respectively. Similarly, consultation fees of Indian doctors can be equated with 3-4 burgers and 5 to 7 Coca-Cola bottles in India. The same comparison made in other BRICS countries have revealed their fees to be equivalent to >20 bottles of Coca-Cola.
Conclusion:Indian doctors charge the lowest consultation fees among the BRICS countries. The general assumption of high consultation fees being charged by Indian doctors, is far from reality, on the basis of the factors analysed.. Interestingly, most of the cost analysis studies on healthcare in India are focused on public spending and the patients’ affordability aspects. The consultation fee of private doctors is never valued in terms of quality of service provided by private doctors in comparison with that of the public health system. Keywords:General practitioners, Specialists, Subspecialists, Consultation fees, BRICS countries, Saloons . —————————————————————————————————————— ——————– Date of Submission: 14-05-2020 Date of Acceptance: 29-05-2020 ————————————————————————————————— ————————————
I. Introduction
Medical expenses are an inevitable part of human life and often considered seriously by all walks of life, both in terms of quality and cost. Evidence on public health spending in India on healthcare is low and hence spending by people on their own is reported as more than four times to that of the government spending1,2. This makes the public thinking and perception of healthcare services as a whole and consultation fees of doctors, in particular, more biased with inclination on the patients’ spending capacity. Therefore, an analysis of healthcare spending from the perspective of the Doctor community is needed for getting a better and holistic picture of the economic perspective of the healthcare system in India. The current survey has been carried out with the objective of analyzing the cost incurred by the doctors in terms of their consultation fees in the private sector.
II. Methods
Doctors are categorized into 3 strata such as general practitioners (MBBS), specialists(MD/MS) and subspecialists (MD/MS with additional qualifications) and a survey on the consultation fees charged by individual practitioners at selected Indian cities and BRICS countries has been made. Further, mean values of the consultation fees of each category of the doctors are compared with ordinary saloons, 5-star saloons, SPAs and the price of popular burger brands and Coca-Cola across the selected cities in India and BIRCS countries for valuing their consultation fees against common other basic personal services like hair-cutting and with those of the popular fast food items. Mean of the fees charged by individual categories of Doctors was calculated from information available in the public domain and compared with means of hair-cutting charges in three types of saloons like the ordinary saloon, 5-star saloon, and SPA at 6 major cities of India such as Bengaluru, Mumbai, Hyderabad, Chennai, Kolkata, and Delhi.
DOI: 10.9790/0853-1905155760 http://www.iosrjournal 57 | Page

Consultation fees of Indian doctors: the myth demystified
III. Results
The consultation fees of Indian doctors when compared with those of other BRICS countries (Fig.1), the former recorded the lowest value, with Brazil>Russia>China>South Africa>India in the descending order. Interestingly, the mean consultation fees charged by Indian Doctors are one-third of the next higher value among the BRICS countries.
Fig. 1. Comparison of the consultation fees of Doctors in BRICS countries3,4,5,6,7
Values are means of fees of all categories of doctors (i.e. general practitioners, specialists, and subspecialists) in INRs.
Table 1 compares the mean consultation fees of Indian doctors with the cost of hair-cutting service offered at different types of saloons for men. The values in parentheses indicate how much percentage the doctors’ fees are for the hair-cutting service. In fact, hair-cut at the SPA costs more than double the fees charged by a general practitioner and near to double to that of specialist doctors.
Table 1. Comparison of consultation fees of Indian Doctors3,4,5,6,7with hair cut fees at Men’s saloonsand SPA in India8,9,10,11,12,13,14,15,
CONSULTATION FEES OF DOCTORS IN BRICS COUNTRIES
1
Brazil [VALUE]
Russia [VALUE]
China [VALUE]
S Africa [VALUE]
India [VALUE]
Types of Doctors
General practitioner (MBBS)
Specialist (MD/MS)
Subspecialist (MD/MS + specialization)
Consultation fees (in INR) Mean
Ordinary saloon fees (in INR) Mean(% of Doctors’ fees)
5 Star saloon fees
Mean(% of Doctors’ fees)
734.21 (140.68) 734.21 (130.43)
734.21 (102.68)
SPA fees
Mean(% of Doctors’ fees)
1051.25 (201.43) 1051.25 (186.76)
1051.25 (147.02)
521.88 347.14 (66.57) 562.88 347.14 (61.67)
715.00 347.14 (48.55)
In another attempt value of the consultation fees of Indian doctors is compared with prices of popular fast food items like the burgers and Coca-Cola. The doctors’ fees are converted to the number of pieces of the food items (Table 2). Accordingly, fees of a general practitioner are equated to 3 to 3.5 burgers and 5 bottles of Coca-Cola. The figures are not much different in the case of specialist and subspecialist doctors (Table 2).
Table 2. Comparison of popular fast food item prices with consultation fees of Indian Doctors16,18,19
Types of Doctors
General practitioner (MBBS)
Specialist (MD/MS)
Consultation fees (in INR) Mean
521.88 562.88
McDonald Burgers
Mean (Nos equivalent to Doctors’ fees ) 148.5 (3.5) 148.5
KFC Burger
Mean (Nos equivalent to Doctors’ fees ) 153.33 (3.4) 153.33
Coca-Cola*
Mean (Nos equivalent to Doctors’ fees ) 100.00 (5.2) 100.00
DOI: 10.9790/0853-1905155760
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Consultation fees of Indian doctors: the myth demystified
Subspecialist (MD/MS + specialization)
per 2Lpack 715.00 (3.8) 148.5 (4.8) (3.67) 153.33 (4.67) (5.6) 100.00 (7.1) Table 3 compares the mean consultation fees of doctors in BRICS countries with that of the price of Coco-Cola in respective places. The figures indicate the lowest number of bottles equated to the fees of Indian doctors in comparison with other countries. Table 3. Comparison of Coca-Cola prices with consultation fees of Doctors in BRICS countries16,17 Countries Consultation fees (in INR) Mean Coca-Cola
Mean (Nos equivalent to Doctors’ fees )
97 (90.46)
102 (24.5) 100.00 (7.1) 87.00 (25.86)
82.00 (21.95)
Brazil 8775 Russia 2500 India 600 China 2250 South Africa 1800
*per 2Lpack
IV. Discussion
Patient safety and affordability are the key rulers of the healthcare system. As far as the safety of the patients is concerned, accessibility and availability of timely treatment are the crucial factors. Affordability is often over projected in Indian context while analyzing the healthcare system, particularly with reference to the private healthcare professionals and the facilities. While considering the practical aspects of the public-private divide on healthcare service in India the major point to note is the quality of the service offered by the two sectors. The quality of healthcare service in the public healthcare system is comparatively poorer to that of the private sector in India as reported by several studies19,20,21. Prices of drugs have been identified as the major factor contributing towards the cost enhancement of healthcare22 service in India, which is overlooked in most of the analyses. The context is well illustrated by the concept of “70:70 paradox”, which refers to the condition in which 70 percent of healthcare cost is being borne by the patients, of which 70% accounts for the cost of medicines23, The consultation fees of the private doctors, in fact, acts as a marginal factor in the whole healthcare service expenditure from the patients’ perspective, but gets over-amplified in the public perception. This needs to be valued in terms of the quality of the healthcare service in the private sector, which is again not being projected in many of the cost analysis studies.
V. Conclusion
Indian doctors charge the lowest consultation fees among the BRICS countries. The current study has established that the general assumption of high consultation fees being charged by Indian doctors is far from reality. Another interesting fact is that the cost analysis studies on healthcare in India are more focused on public spending and the patients’ affordability. The consultation fee is never valued in terms of quality of service provided by private doctors in comparison with that of the public health system.
References:
[1]. PavanSrinath, et al, 2018, A Qualitative and Quantitative Analysis of Public Health Expenditure in India: 2005-06 to 2014-15, The Takshashila Institution, July, 2018.
[2]. Nivedita Rao, 2018. Who is paying for India’s healthcare? https://thewire.in/health/who-is-paying-for-indias-healthcare
[3]. https://www.msh-intl.com/en/europe/individuals/brazil-country-guide.html
[4]. https://www.expatica.com/ru/healthcare/healthcare-services/doctors-in-russia-
1095654/?utm_source=301&utm_medium=redirect&utm_campaign=2020-05-01
[5]. http://global.chinadaily.com.cn/a/201909/02/WS5d6c76bca310cf3e35569212.html)
[6]. https://www.justmoney.co.za/news/2019/01/18/the-cost-of-being-sick-in-south-africa/
[7]. https://www.practo.com/
[8]. https://lbb.in/
[9]. https://www.bblunt.com/
[10]. http://www.mydala.com/
[11]. https://magicpin.in/
[12]. https://www.bouncehere.com/
[13]. https://blog.mojojo.com/
[14]. https://www.bodycraft.co.in/
[15]. http://www.lucassalon.com/
[16]. https://www.tradeindia.com/
[17]. https://www.expatistan.com/
[18]. https://online.kfc.co.in/
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Consultation fees of Indian doctors: the myth demystified
[19]. Prinja S, Bahuguna P, Pinto AD, Sharma A, Bharaj G, et al. (2012) The Cost of Universal Health Care in India: A Model Based Estimate. PLoS ONE 7(1): e30362. doi:10.1371/journal.pone.0030362
[20]. Hammer J, Aiyar Y, Samji S (2007) Understanding government failure in public health services. Economic and Political Weekly 42: 4049–4059.
[21]. Levesque JF, Haddad S, Narayana D, Fournier P (2007) Affording what’s free and paying for choice: comparing the cost of public and private hospitalizations in urban Kerala. Int J Health Plann Manage 22: 159–174.
[22]. Rane W (1996) Analysis of drug prices, 1980–1995. Economic and PoliticalWeekly August 24: 2331–2980.
[23]. Golechha M (2015) Healthcare agenda for the Indian government. Indian J Med Res 141: 151-153.
Sumangala Bhat K. “Consultation fees of Indian doctors: the myth demystified.” IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 19(5), 2020, pp. 57-60.
DOI: 10.9790/0853-1905155760 http://www.iosrjournal 60 | Page

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