While fee splitting between doctors is deemed unethical by the Medical Council of India (MCI), the statutory body is more concerned about the unethical practices adopted by corporate-run hospitals who pay referral fees to doctors.
“The larger problem these days is not doctors indulging in fee splitting. Big corporate hospitals and diagnostic centres are now giving out cheques to doctors who refer patients to them. They even ask for the PAN number of the doctor so that they can show it as a marketing expense,” said Dr Arun Bal, convenor of MCI’s ethics committee.
The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations barring doctors from accepting or giving referral fees does not apply to a corporate hospital. “This has led to this unofficial, underhand dealing gaining legitimacy,” said a senior doctor.
“This practice cannot be stopped by the MCI. There is no statutory authority governing hospitals. Only the government can take some action, and since health is a state subject, only the state governments can do something about this,” said Dr Bal.
“But the doctors cannot remain mute spectators to this practice. It is finally the community of doctors that is affected,” said Dr Kishore Taori, president of the Maharashtra Medical Council (MMC).
Dr Taori said that the MMC has not received any complaint regarding the fee-splitting practice. “We are not a policing agency. We act on complaints by agencies and try to find the truth,” said Dr Taori.
Many doctors say the system helps them get patients, especially early on in their careers. “Before they are established, at least for a year, doctors have to approach general practitioners for them to refer patients,” said a senior surgeon who practices in the western suburbs.
He added, “Everyone would like to follow ethics. But in a city with severe competition, it is difficult.”