Working in India's private hospitals many doctors are under pressure to carry out tests and procedures that are not essential in order to meet revenue targets, according to a report published in the journal The BMJ.
"Doctors who face pressure from hospital management to overprescribe surgeries or investigations fear for their livelihood," explained Gautam Mistry, a Kolkata-based cardiologist.
"Also they need to practice for a certain number of years, and by complaining they would be jeopardizing their career," he pointed out.
Pune-based gynecologist Arun Gardre said the main aim of multi-speciality hospitals in India is to generate revenue and profits for their investors. "In the race to earn higher profits, conscience takes a back seat, and doctors are encouraged to indulge in unethical practices," Gardre noted.
However, some doctors, including Devi Shetty, chairman of the Narayana Health Group which runs 32 hospitals for profit in 20 locations in India and abroad, disagree about the ubiquity of financial targets for doctors.
According to Shetty, setting financial goals for a doctor is not a common practice in India, Narayana's hospitals do not set financial targets for doctors but do set performance targets to raise efficiency, Shetty said.
The Medical Council of India is responsible for institutional regulation of medical services, explains Bangalore-based journalist Meera Kay who wrote the BMJ report.
"But the MCI's reputation is in tatters -- its inability to collect data on alleged medical negligence and general failure to bring prosecutions instill no confidence," said Kay wrote in the report published.