Rogue doctors are increasingly using tricks to rip off patients, The Standard can reveal.
The unethical medics are prescribing more medical tests and prescription drugs than are unnecessary in order to pocket hefty commissions from private facilities where they refer patients.
In a shocking betrayal of the Hippocratic Oath, by which physicians swear to treat the ill to the best of their ability, the doctors give their patients the false belief that the high number of tests they are made to undergo is evidence of ‘thoroughness’ in the diagnosis and treatment.
Mostly targeted for ripoff are patients who have medical insurance cover or are perceived to be financially well to do.
The Standard uncovered the scheme after interviews with various medical personnel at both public and private medical facilities.
“Medical tests are very important in diagnosing diseases. But when doctors have a financial interest, they tend to over-prescribe them just to increase their income. They may do that consciously or subconsciously. This increases costs of healthcare,” said a prominent medical doctor in the city who didn’t want her name to be revealed.
The major tests apparently being over-prescribed are radiology-related tests such as CT Scans, ultra sounds, MRI tests and X-rays. Others are expensive medical laboratory tests as well as drug prescriptions.
It has emerged that this breed of greedy doctors are increasingly demanding huge ‘commissions’ or more bluntly, bribes, to refer patients to facilities that offer medical tests services.
If such facilities fail to ‘play by the rules’, they lose the patients that the doctors would have referred to them. Patients end up being referred to rival facilities that may yield to the pressure to part with bribes.
“Those who pay the bribes often pass the additional costs to the consumers. This means it is the patients who bear the higher costs of healthcare just to satisfy the greed of some doctors,” said the
Further investigations reveal that new foreign entrants into the lucrative market of radiology are fueling the vice.
Entice doctors
They often entice doctors with generous ‘commissions’ to send patients to their facilities in order to capture and grow their market share.
In other cases, many doctors are quietly investing in the lucrative businesses that offer medical test services. In such circumstance, the patients are prescribed tests and directed to where they can have them done ‘easily’.
A similar vice is also becoming rampant in private hospitals. Often, such facilities have obtained the expensive machines on credit and are keen to generate business that would pay back the debt. “We are under a lot of pressure. If you don’t send patients for a battery of tests, you are seen as letting down the hospital that has employed you,” confessed a doctor who did not want to be named for fear of losing his job.
Among the victims in the alleged scam is Tabitha Muthoni, a business lady who went to a hospital with stomach pains.
“The doctor ordered that I get a Sh6,000 stomach scan to confirm if I had ulcers. When the tests turned out negative, the same doctor ordered for a lab test but I told him that I did not have more money for the test. He gave me some tablets and told me to return when I get the money for the test,” she recalls, adding: “But since I felt well after taking the tablets, I never went back for the test. I now keep wondering if the tests were necessary in the first place.”
National Chairman of the Kenya Medical Association Dr Elly Nyaim admitted that a ‘few rotten apples’ in the medical profession may be engaging in this vice but insisted that the vast majority of Kenyan doctors are self-respecting professionals who prescribe tests only when they deem fit. “This problem may be there but it is grossly exaggerated. It is unwise to paint all doctors with one brush when the vice could only be perpetrated by a few,” he said.
Chief Executive Officer at the Association of Kenya Insurers Tom Gichuhi said that insurance companies have a ‘strong feeling’ that many medical tests requested by medical professionals are not necessary.
“The dilemma we have is that despite our strong reservations about the tests and their high costs, we cannot challenge doctors in their field because they always insist that the tests were necessary for the health of the patients,” he said.
But he indicated some firms that underwrite health insurance have begun employing medical doctors to scrutinise the necessity of medical procedures and tests.
Director of Medical Services Dr Nicholas Muraguri said it is illegal and unethical for medical practitioners to benefit from medical tests they prescribe.
“We call on Kenyans who feel that the treatments or tests they have received from a hospital or a doctor have been motivated by financial reasons rather than their well being to report to us. We will investigate and take action in line with the Professional Code of Conduct,” he said.
-The Standard
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