Oath of Hypocrites

The Hippocratic Oath generally spelt out how doctors should ethically practice their trade. But, you should know that I intentionally avoided using the word medicine. That was in another millennium. Times have changed. There is a new ‘oath’ that offers doctors commissions that incredibly a Margao-based hospital published, without a care in the world, which is how I have a copy. If Hippocrates were to come alive out of the blue, my diagnosis tells me he would have gone prostrate equally swiftly and would have to be wheeled swiftly into the ICU. The commissions this private hospital offers speaks for itself.

Laparoscopic surgery
Gall stones surgery -cost Rs 25,000, doctors commission Rs 3,500; laparoscopic appendix Rs 12,000, Rs 1,500; laparoscopic hernia Rs 15,000, Rs 2,500.

Cancer
Ca breast surgery -cost Rs 20,000, doctors commission Rs 2,500; thyroid Rs 20,000, Rs 3,000, Ca colon stomach Rs 25,000, Rs 3,500.

Urology
PCNL (kidney stone) surgery -cost Rs 25,000, doctors commission Rs 3,500; URS (ureteric stones) Rs 15,000, Rs 2,500; TRUP (prostate) Rs 20,000, Rs 3,000; bladder stone Rs 10,000, Rs 1,500.

Gyneacology
LAP hysterectomy(hyst) surgery -cost Rs 30,000, doctors commission Rs 3,000; Lap myomectomy Rs 30,000, Rs 3,000; Diag hyst + lap for infertility Rs 10,000; Rs 1,000; open hyst Rs 20,000, Rs 2,500; open myomectomy Rs 20,000, Rs 2,000; LAP for cyst, ectopic pregnancy, adhesiolysis Rs 20,000, Rs 2,000; hysteroscopic procedures fibroid Rs 15,000, Rs 1,500.

Physician heal they self

So far, the central government’s efforts to curb bribing doctors have been like giving the fox the job of guarding the henhouse, despite the fact that more than a quarter of the Organisation of Pharmaceutical Producers of India (OPPI) account for 70% of the drug market in India and who are subsidiaries of companies that have been penalised in the US for illegally promoting various drugs through inducement. Recently, Pfizer was fined $2.3 billion in one of the biggest healthcare fraud settlements. It wined and dined doctors sending them on exotic trips. Eli Lilly was fined $1.42. Glaxosmithkline (GSK) has reserved $400 million to settle charges of promoting unapproved use of drugs and of kickbacks to doctors related to several products. Bristol-Myers Squibb was fined $515 million in 2007. There’s more to this.
The huge profit margins on drugs big pharma companies make, to all intents and purposes, allow them to effectively bribe doctors. In fact, small-scale manufacturers of drugs have always maintained that drug prices can easily be brought down 50 per cent. But if big pharmas did that, would they have the money to bribe doctors, which includes sending them on holidays abroad and in India?

Healing or self-healing

A doctor told me a rep of a Chennai-based pharmaceutical company (name withheld) whom he described as ‘paan chewing and looking more like a thug’ offered him free encyclopaedias to begin with (he was starting out his practice) and a laptop next. The rep’s complaint was that pharmacies in his jurisdiction in Tiswadi were not prescribing his company’s drugs. A representative of an ethical pharma company said he received complaints from doctors of bribes being offered. Pharmaceutical companies pressurize pharmacies to sell their drugs, even if a doctor prescribes another drug; which is precisely why you never seem to get the drug you were prescribed. Which is why, often what should be a quick visit to the family doctor turns into a merry-go-round if you dare insist on every letter of the word on your prescription.

‘Vitamin M’ is also administered by a certain hospital into the veins of your traffic cops and the 108 ambulance service, to ‘induce’ them to rush trauma patients to the hospital. Breaking the Hippocratic Oath in Calangute and the coastal tourist belt extends to bribing hotel staff and taxi drivers to become ‘inclined’ towards certain private clinics, especially one near Mapusa, and particularly dental clinics.

A friend who got an attack of gastritis in the night at a resort in Anjuna had to shell out Rs 800 as doctors’ fees. The irony was that the resort owner was a friend whose friend the doctor was! This particular doctor makes a killing (quite literally) by preying on foreign tourists at resorts!

Government in intensive care

Sent there by the mushrooming of private hospitals, the government sees to it that all the major hospicios, including the health centres, are virtually redundant. The common refrain of doctors is ‘we are short of drugs and consumables.’ The Corlim health centre, built in a remote part of the village, is as a result, barely accessible.

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