Gynaecologist Dr. Arun Gadre interviewed 78 doctors across India on ethical topics to indicate the extent of decline of rationality in the private medical sector and presented an article in the British Medical Journal.
Irrational drug prescribing, kickbacks for referrals, and unnecessary investigations and surgical procedures were the common practices of doctors.
Dr. Gadre's article mentions the "sink test." The referring doctor advises a battery of laboratory tests despite no suspicion of pathology. Only a few of the tests are performed and the extra blood collected is dumped in the sink. Fabricated results are then given in the normal range for all tests that were not performed. The patient pays a large sum, which is shared by the referring doctor and the pathologist.
A general practitioner in Maharashtra said that doctors get Rs.30,000 to 40,000 for referring patients for angioplasty. A pathologist said that only three out of 150 doctors contacted were willing to refer patients for investigations without kickbacks.
Another doctor said gynaecologists performed ultrasounds without indications in pregnant women who complained of trivial abdominal pain and fabricated false reports of cervical abnormalities and advised the women to have cervical stitches to prevent miscarriage.
Dr. Gadre wrote, "Paying money does not guarantee good healthcare. The private healthcare system largely treats patients as revenue generators, without rationality or medical logic."