Home Book retailers ‘When the heart speaks’: Cardiologist’s book exposes ‘practice of cuts’ in Indian healthcare

‘When the heart speaks’: Cardiologist’s book exposes ‘practice of cuts’ in Indian healthcare


PTI, Sep 11, 2022, 12:11 PM IST

Picture for Representation (PTI)

From doctors charging patients for coronary stents without allegedly implanting them to getting lab commissions for their referrals, a new book ‘When the Heart Speaks’ highlights the infamous ‘practice of cutting in the Indian healthcare system.

The book is a memoir by renowned cardiologist Dr. Upendra Kaul. One of its chapters – “Experience in Private Heart Hospitals” – exposes how the “unholy nexus” between doctors and pharmaceutical companies results in patients being subjected to unnecessary surgeries, tests and medications.

Dr Kaul had his first encounter with the ‘cutting practice’ in 1997 when a doctor demanded Rs 30,000 as his share for referring five of his patients to him for angioplasty. At that time, “every case referred for Angiography and Angioplasty got a bribe of Rs 5,000 and Rs 15,000, respectively,” he claimed in the book.

“Seeing this trend, doctors went a step further and started paying their referring physicians an advance of Rs 1 lakh and adjusting it as patients arrived – an ingenious move,” writes the Dr Kaul, who has been practicing as a cardiologist in Delhi for about 40 years.

For the uninitiated, the term discount practice refers to giving or receiving money or gifts in the form of professional fees or commissions to encourage or increase patient referrals.

The threat has extended its tentacles throughout the medical field, including radiological diagnostic and biochemical laboratories, according to Dr. Kaul, who is currently chairman and dean, academics and research, at the hospital and medical research center of Batra. So for every medical test ordered, 20% of the bill goes to the referring doctor, leading doctors to recommend “unnecessary tests and drugs” to patients, he writes in the book.

“Pharmaceutical companies have also seen their business flourish. Reputable doctors and specialists received gifts, such as fancy televisions, refrigerators, air conditioners and cars based on prescriptions. “General practitioners prescribed unnecessary drugs, several types of vitamin supplements and specific brands of drugs, and received cash reimbursements,” laureate Padma Shri claims in the book.

Very often, “prescriptions were written in codes that could only be deciphered by specific chemists,” he adds.

Notably, these unnecessary and wasteful procedures are not limited to diagnostic angiograms only, and also include “angioplasties and stenting” in non-critical cases.

For example, one such case reported in the book involves a doctor advising his patient for immediate angioplasty and placing a stent. Then he took the money for the stent and apparently did the procedure in the lab. However, soon news leaked from the lab that no stent had been placed.

Dr. Kaul, to whom the case was referred for verification by a state government, after performing several tests on the patient, confirmed the absence of any stents in his report.

But even 20 years after the incident, no action has been taken against the accused doctor, the Kashmir-born cardiologist alleged.

“These unnecessary procedures are not only ethically wrong but sometimes cost the life of the subjects due to the clotting of the stents. . . and cause a lot of morbidity for these unfortunate subjects,” he warns.

“When the Heart Speaks” is the life story of Dr. Kaul – from his ancestral village in Kashmir to becoming one of the country’s top cardiologists.

(This story has not been edited by Udayavani staff and is posted from a syndicated feed)