Commission trade traps patients
Patients in the country are increasingly becoming captive of an unholy nexus of doctors and diagnostic centres driven by unethical greed.
It has become a common knowledge in the society that doctors tend to prescribe unnecessary medical tests for their patients in exchange for commissions from diagnostic centres, driving up the cost of treatment.
There are 7,623 authorised private diagnostic centres in the country, 780 of which are in the capital, according to the Directorate General of Health Services (DGHS).
Some doctors admitted to The Daily Star that the practice does exist, and doctors get 10 to 30 percent commission from each test they suggest.
"Usually, renowned diagnostic centres offer low commission. But less popular centres pay more, as they need promotion and doctors' attention," said a cancer specialist of Bangabandhu Sheikh Mujibur Rahman Medical University.
"If an x-ray costs 300 taka, the doctor gets 120 taka just for referring the patient to a particular diagnostic centre," said another doctor.
Staff of some pathology centres also admitted to offering commission to doctors in exchange for referrals.
A marketing manager of Labaid Diagnostic Centre said they know that doctors get commission for referring patients to diagnostic centres, but they do not know how the transactions take place.
He also said the test fees vary from centre to centre due to varying prices of machines and equipment.
"If we procure a good quality and expensive machine, certainly the charge will be a little higher," he said adding Labaid charges Tk 4,000 for a CT Scan, and Tk 1,500 for an EEG.
Whereas, CT Scan at Comfort Diagnostic Centre costs Tk 3,580.
Many patients complained that doctors prescribe different tests even for simple fever, cold, and coughing, and also dictate which diagnostic centres the patients should go to.
The situation is so bad that many patients are scared of going to doctors fearing astronomical expense for unnecessary diagnostic tests.
The hospital and clinic section of DGHS, which is supposed to look into the matter, uses manpower shortage as an excuse for weak monitoring.
Sources said during the last interim regime the then health adviser M Shawkat Ali formulated a committee to fix generalised fees for such tests at private diagnostic centres.
Soon after the Awami League government assumed power, the health minister along with other government high ups sent the policy to DGHS for reviewing. The initiative is yet to bear any fruit.
DGHS Deputy Director (Hospital and Clinic) ABM Lutful Kabir said formation of a policy to control private clinics and diagnostic centres is underway.
"We don't have much to do directly about the commission business and diagnostic tests. Only doctors can say which tests are needed for patients," he said adding, a positive change in institutional practice within the public health sector however may help to improve the situation.
According to a relevant law, civil surgeons are supposed to monitor diagnostic centres at the district level, and in the capital DGHS teams are supposed to do the job, Lutful Kabir said.
But the law does not specify how often the inspectors should visit the diagnostic centres, he added.
Comments