Many pharmacy owners in Kerala have forged partnerships with doctors for mutual benefit. Doctors not only get a place next to pharmacies to check patients but also plenty of cash, gifts and travel expenses. In return, the pharmacy owners get a steady flow of customers to fleece. Some pharmacy owners even gift a clinic to doctors on partnership.
Many such clinics can be found in rural areas in northern districts. Mostly a clinic will be just a room adjacent to a pharmacy, whose owner will pay the rent and arrange other facilities. After that, doctors will be identified. The clinic will be started after striking a deal with one or two suitable doctors from private or government hospitals. These doctors could be looking for a place outside their homes for private practice. Hence, the deal will be beneficial to both parties. Each doctor will spend two or three hours daily in the clinic and gets a certain percentage of profit from the pharmacy owner in addition to consultation fees. In return, the doctor must prescribe only branded medicines available in that pharmacy.
A licence worth Rs 25 lakh
When pharmacy licence was made mandatory for medical shops in hospitals, some private hospitals objected strongly. They feared that if they took the licence, they would not be able to loot patients by charging exorbitant rates because drug inspectors would come to check medicines. To put pressure on hospitals to take the licence, the drug control division stopped wholesale dealers from supplying medicines to hospitals. After one week, hospital authorities approached the drug controller for licence.
The first applicant was a major hospital, and it had good reason. That hospital used to make a profit of Rs 3.5 lakh a day by selling medicines. When it did not have medicines for one week, its loss reached Rs 25 lakh, and that money went to nearby pharmacies. After the hospital’s finance officer pointed out this data, its authorities were forced to take a pharmacy licence. Still, the previous government ordered that a pharmacy in a clinic run by a single doctor did not need a licence. Legal experts in this field point out that the order is illegal. Most hospitals exploit the helplessness of patients by pricing medicines, which they get at low rates from companies, exorbitantly.
Android TV is a good medicine
Many doctors in big hospitals do not take commission from drug companies in cash. Instead they demand gifts, such as sponsored tours, vehicle insurance or anniversary present, among other things, as commission. A doctor in Kochi changes TV at home every year. The doctor insists on being the first person to buy a new model, but at the expense of drug manufacturers. A few months ago, the doctor demanded an Android TV from the medical representative of a major pharmaceutical company, who was a novice. Only after it reached home did the doctor agree to meet the representative next week.
Referring doctor
There are marketing executives who approach small-time doctors to refer patients to major hospitals. At a clinic in a northern district, a media person, who was acting as a patient, witnessed the following exchange:
“Doctor, this month you referred fewer people, only ....” “No, you got it wrong. I have a list.” (He hands over the list.) “Then, I got the number wrong. Now, please keep this.” (He places a cover on the table.)
What was in the cover, known as referral cuts, could have been cash, gift vouchers or other things.
It’s only an appendix, let’s take it out
A young woman who alleged that a private hospital tried to perform an unnecessary surgery, had this to say: “I went to the hospital with abdominal pain. The doctor who examined me said 95 per cent it could be appendicitis, and, most likely, the surgery would be done that day itself. When I asked about taking a scan, the reply was not to take risk. Anyway, it was good that I went to another hospital. A scan revealed that I had lymphadenopathy, and it was cured by taking medicine. When I met the previous doctor again and conveyed this, he said, 'Anyway appendix is an unwanted organ. I just thought of not taking any risk.' What can we say to such people?”
Vanishing neurosurgeon
When a revenue department official was entering a road on a bike from a side lane near his house, some vehicle hit his bike, and he suffered head injury. He was admitted in a super-specialty hospital in south Kerala. The report said his condition was serious. Even after two days, his condition did not improve. His colleagues in Thiruvananthapuram smelt danger. But hospital authorities were not giving any clear information. But when a ‘scene’ was created in the hospital, a nurse revealed what was happening. The neurosurgeon had gone to the United States on a two-week programme, and the treatment was prescribed over phone. His colleagues forced the hospital to discharge him and took him to Thiruvananthapuram Medical College. Because of that, he is still alive.
(Prepared by Jayan Menon, N.V. Krishnadas, Gayathri Jayaraj and Joji Simon and compiled by George Varghese)
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