In the month of April, Dr H.S. Bawaskar of Mahad in the Raigad district received a cheque of `1,200 from NM Medical, Pune, a diagnostic chain. Upon enquiring about the cheque with the centre, he was told that it was a payment towards “professional fee” for referring his patient to them.
He wrote a protest letter to the Pune centre and asked to return the money to the patient instead. The money was subsequently given to the patient. And he in turn filed a case against “cut practice”, as it is popularly termed in the medical industry, with the Maharashtra Medical Council (MMC), a quasi-judicial body governing the working of the medical profession.
This is probably the first complaint of such nature, since an RTI query to Medical Council of India (MCI) in 2011-12 did not identify a single such complaint in the preceding 10 years.
The complaint by Dr Bawaskar has brought out a very discreet but rampant practice, out in the open. What’s more, it has also set a momentum for a bunch of doctors who shun the cut practice vociferously.
A Vile Parle-based psychiatrist, Dr Vani Kulhali, has written a letter to the chief justice of the Bombay high court requesting to intervene in the “medical malpractice case”. In her letter, Dr Kulhali appeals, “I have seen the harm done to the community by ‘cut-practice’ and believe that it is a horrible form of corruption that should be immediately stopped.”
“A patient goes to his doctor in pain and desperation, with a hope not only of treatment but also of empathic guidance and support. If the doctor is motivated by empathy and informed by scientific facts, this patient can get what he needs. This is a basic human right. There is no law that forbids the doctor from framing and then claiming his/her fees for this service. That amount may be high or low, as per the doctor’s judgement. In spite of this, it is my personal
experience that all patients pay the fees asked of them. Then what is the need to fool the patient into
paying through the cut-practice network,” she further writes in the letter.
Interestingly and encouragingly, it is not Dr Kulhali alone who has written to the Chief Justice of the Bombay high court. Through her network, doctors who personally do not indulge in cut practice and oppose it have also written letters in their individual capacity. One of them is Dr Mangesh Thorat from the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, United Kingdom.
Though MCI’s code of ethics for doctors prohibits any rebates and commission to doctors, Dr Kulhali in her letter states that she deems MMC, the state level body, unfit to tackle the menace.
“All members of the current MMC are doctors or bureaucrats. They are not well versed in judging misdemeanours of this (financial and ethical) nature. Their role in this case will be limited to merely hear the case and settle it. Secondly, they are mostly busy doctors doing the
council work in honorary capacity and cannot spare the time or energy required. Thirdly, being doctors, it will not be easy for them to be objective in the respect of a practice that has spread its tentacles over most of the medical community. Sometimes fraternal ties make it difficult to give out proper decisions. Therefore, I have serious doubts about the competence and credibility of MMC to handle this case,” she writes.
But, the president of MMC differs. “I cannot comment what people want to think of/about MMC and its
functioning and capabilities. If there is a complaint and there are sufficient evidences to establish that one has indulged in cut practice/rebate/commission, then MMC can take a wide range of actions depending on the severity of the case and the behaviour of the doctor,” said Dr Kihsor Taori, president MMC.