WHY DOCTORS INDULGE IN CUT-PRACTICE?

More than 90% doctors in India do 'cut-practice'. In my 8 years of work, I have interacted with many doctors of different sepcialities, and tried to elicit their views on this practice. Majority were completely candid , about their involvement and each had their 'reasons'. Well, they are only excuses or justifications, really. Following is the list-: (This is written in first person, just as the doctors told me, but with some alterations to improve clarity)

1. It is impossible to get patients without giving cuts to neighbouring general practitioners. If I have to give cuts and have enough money to do so, I have to also take cuts-just plain logical maths!

2. I have spent so many of my best years and a lot of my father's money on my education. I do not have further time or patience to wait till I set my practice. So this is a good short-cut.

3. Everybody is doing it. So why should I lose out on a great opportunity by staying out. Consensus is a great way to solve ethical dilemnas!

4. I got 99% in standard 12 and stood 5th in the merit list (In those days). I took up medicine. My neighbour's son got only 90% (in these days) and he took up BMM. Now he earns in lakhs in the beginning itself, while I dont earn so much. This is unfair-I have more proved intelligence (sic), I should earn more

5.I wanted to do specialisation but could not do it. See these specialists-charging so much right out of college. This is not fair-they have to learn to respect me and I am going to make sure they realise my importance in their life by controlling their practice- and charging for it

6.

6. I am an Ayurvedic physician but I don’t have the patience to practice Ayurvedic diagnosis. My Homeopathy colleague also feels that Homeopathic history taking is a long and painful job. Better to use modern diagnostic methods. Besides, the diagnostic centres and specialists pay handsome (cuts) money

7. When I can earn more through cut-practice than through actual practice, then why not participate in it? Only a fool will take the stairs when an elevator is available.

8. The best part of cut-practice is that- the patient won’t know and the income-tax department won’t know (very soon I will get so used to it that even I wont know)

9. The cut-practice which I do is completely legal- I pay “my” GPs by cheque and claim the amount as business-expense. Do you think I would have been spared, if this was not very legal and legitimate?

10. Most doctors have cars and send their kids to ICSE schools. I don’t want to appear inept and unsuccessful by not matching up to them. By doing cut-practice, I can fulfill my aspirations faster

11. I don’t believe in ethics, law and all that garbage. I do what works for me-and cut-practice works very well in bringing business (sic). In fact, to tide over the festival season slack, I have announced a special festival offer of “100% cuts”. One has to do SOME marketing.

12. It is all the Government’s fault-we are not allowed to advertise, so how will anyone know that I am here? This job is done by “my” GP and it only right that I have to pay him. By keeping it on a percentage basis, I can keep up his motivation to work hard for me and send more patients . (This HR management!)

13. I don’t believe in patient’s right to choose. A patient cannot even understand the difference between spondylitis and spondylolisthesis, how do you expect them to choose the proper person to treat? I make this choice for them. Now the problem is: there are too many specialists with complicated degrees that I find difficult to decipher. Cut-practice makes it very easy. Percentage is the real winner. After all, a doctor willing to invest so much in his practice and sacrifice his income for setting it up must be really serious and committed and it is my duty to encourage him.

14. I have a medical degree, and have studied my specialization through correspondence course. But believe me, I can treat any complicated case with full confidence. In fact, I feel I am much better than many of these ‘qualified specialists’. Till I make an impression, I will give cuts to the local GPs. For some time at least, I will have to use this method to make up for my lack of ‘proper’ qualification

15. I have practiced for 35 years, and now everything is so expensive. Patients are in constant denial and expect me to charge them the same rates, as I did in the 70s. The problem with family practice is that you know your patients so long, and so intimately that it becomes difficult to charge proper fees for fear of offending them. However, I found that patients are highly appreciative of tests and specialist opinions, while all these specialists and diagnostic centres are competing amongst themselves to get patients. So the common solution for fulfilling all the above problems is cut-practice and everybody remains happy. A newspaper even featured me once for my low fees and ‘community-spiritedness’

ALL are welcome to add to this list