We do not wish to alarm our readers but it is useful to bear such practices may be happening around us. Surely, there are black sheep in every profession globally. But important to be wary, check what you are being asked to get done, and pay for what?
A news report classifies that in India, 55% of heart surgeries, 48% of hysterectomies (uterus removals), 47% of cancer surgeries, 48% of knee replacements, 45% of caesarean deliveries, and many shoulder and spine surgeries are fake or unnecessary. (BMJ Global Health)
In one well-known hospital, a 14-year-old boy who had died was kept on a ventilator for a month under the pretence that he was alive and being treated — and only later declared dead. After complaints, the hospital was found guilty and paid ₹5 lakh in settlement. But what about the emotional trauma inflicted on the family?
Many times, fake “emergency surgeries” are conducted on already deceased patients — families are asked to pay urgently, and later told that the patient died during surgery. The hospital then collects the full surgery cost. (Source: “Dissenting Diagnosis” – Dr. Gadre & Shukla)
The medical insurance fraud is equally horrifying. Around 68% of Indians have medical insurance, but when needed, most claims are denied or only partially paid through manipulations — forcing families to bear huge costs themselves.
Over 3,000 well-known hospitals have been blacklisted by major insurance companies for making false claims. During the COVID period, many big hospitals falsely claimed insurance money for fake COVID cases.
Everyone knows about the “Hospital Referral Scam.” Doctors refer patients claiming serious illness to large, branded hospitals like Apollo, Fortis, Apex, etc., often as part of referral programs where hospitals pay doctors per patient sent.
Another major fraud is the “Diagnosis Scam.” Income Tax raids on some reputed pathology labs in Bengaluru uncovered over ₹100 crore in cash and 3.5 kg of gold kept aside as doctor commissions. Doctors refer patients for unnecessary tests, earning 40–50% commissions. Many labs falsify reports after performing only 1–2 real tests. Out of nearly 200,000 labs in India, only about 1,000 are certified — yet the business is highly profitable.
Similarly, pharma companies run their own massive bribery schemes. Around 20–25 big drug firms spend ₹1,000 crore per year on doctors. During COVID, the maker of the painkiller Dolo was exposed for giving ₹1,000 crore in “incentives.” Doctors receive cash, foreign trips, and luxury stays in return for prescribing specific brands. For example, USV Ltd. reportedly offers doctors ₹3 lakh cash and trips to Australia or the U.S.
The Medical Council of India (MCI), the apex regulatory body, was found complicit. In 2016, a government-appointed committee reported that MCI eagerly approved new medical colleges but deliberately neglected to regulate doctors and hospitals. Doctors routinely violate MCI rules without public awareness. Examples include:
1. Doctors must prescribe only generic (salt) names, not branded drugs — rarely followed.
2. Rule 1.8: Doctors must disclose full fees before treatment — often ignored.
3. Patients’ informed consent must be obtained before tests or treatments.
4. Medical records must be preserved for at least three years.
5. Unethical, dishonest, or incompetent doctors should be publicly reported without fear.
6. Government health scheme scams: Patients (e.g., ex-servicemen) are admitted for minor issues, falsely enrolled under government insurance, and billed for fake treatments. These inflated bills are approved by corrupt officials — hospitals pocket the money.
