Are we just?

“Are we just?” – this question has passed through my neural network so many times in the last 10 years ( ever since I joined a medical school ). And the frequency of such thoughts has multiplied ever since I started practising radiology. I took radiology presuming I could help the patients in the maximum possible way with least harm to the patients (“primum non nocere”). I suppose I have been mostly doing that.


Radiology has established itself as an integral part of the patient care for medical as well as non medical reasons. Medical reasons are well known to the professional as well as the
educated patients. Main issues with diagnostic tests (imaging / non imaging) are the over referral and the issue of IC. Over referral is a tricky thing but that could be accepted as it is worth even if you pick a single tumor for hundred normal brain scans. Most unpardonable is the issue of IC. Primarily for the way the acronym is expanded (I don’t know what to call it – internal cuts / interpretation charges). For the uninitiated it’s the money that is given to the referring clinician by the diagnostic centers for the referral. I am amused how it is called interpretation charges because it is done by a radiologist and he does not get a single paisa of that( i am not jealous ,for sure). Remember the money comes from nowhere else other than the patient’s pockets whether it is deep or shallow.

Hold your breath- the worst one comes now – the commission/ brokerage/ bribe ( looking for cheaper words!) is not a single digit number. It hovers at and above 50%, nothing less. More the cut, more the referrals. Surprise, surprise some of the prominent consultants who looked and talked ethical were the worst offenders. There are doctors who are much dependent on this money to run their practice / lives as it generates a huge amount of unaccounted cash. The diagnostic centers are competing with each other in giving higher IC , to garner larger number of cases.

All this is happening with probably the public, media and the government in the know!
It’s been so surprising that none have had the gumption to challenge this practice which puts the already suffering people under higher stress.

I just wonder why all the fuss is made about ethics and service mindedness in medicine, when a large proportion of the fraternity indulge in this shameful act. Medicine is indeed no more a noble profession except for the smaller percentage of doctors who do not take “bribe” from their patients. They are the only saving grace.

. I am happy atleast that as a consultant radiologist I am not directly involved in this sinful giving or taking bribes, though I am a ineffectual witness to these proceedings. I pray God that this heartless fleecing act comes to an end sooner