Fakes, Frauds and Forgeries of the Indian Medical System
M3 India Newsdesk Oct 26, 2017
Few systems in India are devoid of dishonesty; the medical profession is not an exception to it.
Reported multiple times but still far from being addressed properly, various types of fraud are pervasive in India’s medical system. Here's exploring a few of these murky corners.
“Paid” educational seats
Some of the world’s best doctors are from India, and they can come from some of the most selective institutions in the world. The All India Institute of Medical Sciences (AIIMS), New Delhi, widely considered the best medical college in India, has an acceptance rate of less than 0.1%, which is nearly 35 times more selective than Harvard Medical School, which admits nearly 3.5% of its applicants.
However, far from this pinnacle, India has many medical colleges run by politicians and well-connected business families which have mushroomed mainly to profit from “donations” and “paid seats”. According to a Deccan Chronicle report in 2015, Congress MLA S.A. Sampath Kumar alleged that the government had allowed medical colleges in Karnataka to allot some seats themselves apart from the merit list. He alleged that private medical colleges were charging as much as Rs. 1.35 crore rupees for a medical admission, something which would make medical education absolutely unaffordable for most people.
A report in Lancet (Aug 2015) throws light on how India’s medical education system is hit by scandals.The report states” The admission scandals not only affect the quality of medical education but also the practice of medicine. “Candidates willing to adopt fraudulent means to get into medical colleges are not just denying meritorious students a chance to study but are subverting the system with money. They can try similar means to clear exams during the medical course as well”, Anant Bhan, a bioethicist and adjunct visiting professor at Yenepoya University in Mangalore, told The Lancet.
Reuters news agency report stated that in a 4-month long investigation they found that more than one out of every six of the country’s 398 medical schools had been accused of cheating, according to Indian government records and court filings.
Inspections and accreditations
Government accreditations and inspections are an area where a large number of frauds occur. According to an example in Muzaffarnagar in Uttar Pradesh, Dilshad Chaudhry and nearly 100 of his fellow villagers were called to a large government hospital in December 2015, after being told that a team of “foreign doctors” was visiting for a check-up camp. When they reached the hospital, there was no sign of a check-up camp, instead, all of them were asked to lie down on beds for many hours. Apparently, a lot of the patients had been invited to the hospital only to complete the “quota” of patients which the hospital was supposed to treat in a certain timeframe. In a surprise survey in another children’s ward by the UP Government and medical council inspectors conducted in 2014, it was found that children from a nearby slum were paid some money to be admitted in the children’s ward even though they did not have a medical problem.
Cutting corner (where they shouldn’t)
Many hospitals have been found of sterilizing and reusing certain medical equipment which ideally is meant to be for single use only. In April 2017, 2 reputed hospitals in Mumbai were served show cause notices by the FDA. They were reported to be charging patients for reused devices and/or indulging in the malpractice of using a single-use device multiple times after sterilization. Some devices such as catheters are often sold at three or four times their original price. This has prompted the Maharashtra government to file complaints against 37 hospitals across Maharashtra after finding out that such malpractices are rampant across the state.
The pharma connection
Two articles, one in the BMJ and another in the New York Times document the fact that pharmaceutical companies often conduct “health check-up camps” which then help doctors dig up “health problems” from among their patients and allow them to prescribe medications, often produced by the company which is sponsoring the camp. In August 2016, an employee of a noted pharmaceutical company was reported to have committed suicide due to the extremely demanding sales tactics of the company, including such “check-up camps”. Moreover, it was, or probably is a well-known practice where doctors often obtained favors from pharmaceutical companies in exchange for prescribing medications from that company. This has now prompted the Medical Council of India to dissuade this practice among its members by publishing a code of ethics.
Another problem, which is mostly due to the severe shortfall of doctors in the country is “doctors” having fake degrees. According to the Indian Medical Association, nearly 45% of the people who practice medicine in India have no formal training in medicine. One con artist, Balwant Rai Arora, was a man in his nineties, who was caught by the police in 2011 and he allegedly confessed to having sold nearly 50000 “medical degrees” to anyone who paid him around five thousand rupees. The phenomenon of quacks prescribing medications and even administering injections is well-known in rural India, where most people are too uneducated or desperate to verify a doctor’s credentials, especially when the government health system does not serve them well.
Overall, many members of the Indian medical community go out of their way to serve the community despite severely limited resources, fund crunches and for some, a downright unsafe atmosphere in the hospitals if a patient unfortunately dies. However, there are always those in a system who take undue advantage of the loopholes or vulnerabilities of the system and their patients. Such anti-social elements tarnish the reputation of a profession which is considered to be above all by many people since they are the ones who can literally save lives with their knowledge.
India’s medical system has problems at many levels, and a systemic clean-up is required to save lives and to improve the healthcare scenario in India. This will need concerted efforts from everyone involved and these efforts need to be taken quickly, to prevent more lives from being lost.
The writer is a qualified pharmacist and public health researcher. He is currently working as an independent researcher on an epidemiological research project.
Disclaimer-The information and views set out in this article are those of the author(s) and do not necessarily reflect the official opinion of M3 India. Neither M3 India nor any person acting on their behalf may be held responsible for the use which may be made of the information contained therein.
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