2. UNNECESSARY INVESTIGATIONS
Dr Jana, from Shahid Hospital, Chhattisgarh, explained how unscrupulous doctors cheated patients by advising unnecessary tests. 'First they show that the patient has contracted malaria. They show that by a lab test, and give treatment, but the patient does not get better. Then they do another test and show that the patient has typhoid. Doctors are given whatever reports they want by some labs, on payment of a commission. 'The investigations that are made are also often unnecessary. They are not indicated in the textbooks, but they have been euphemistically termed "routine investigations" just to increase the number of investigations required. '
Endorsing this view, Dr Arjun Rajagopalan, a surgeon from Chennai, said, 'It is a rare patient who gets away with just one or two investigations. All the patients I see hold a list of unnecessary tests.'
A pathologist from a metropolitan city revealed how many unnecessary investigations are advised. 'Take typhoid, for example. If the blood test is performed before the fifth day, it does not reveal anything. But it is carried out every alternate day from the first day onwards. The more expensive a test, the more it is prescribed. A sputum examination is generally sufficient to diagnose tuberculosis in the lungs. But the simple reality is that no test can detect it when the tuberculosis is elsewhere in the body—in the stomach, bones, or lymph nodes. But expensive tests like TB Gold and TB Platinum are prescribed. The more expensive the test, the more the commission.' The pathologist explained the phenomena of 'sink tests': 'This means the sample is just thrown into the sink without testing. The doctor prescribes tests, which by mutual understanding are not actually carried out by the pathologist, who collects the money for the test, and without testing he merely gives a "normal" report. Just one more way of increasing the commission. Many doctors have inadequate knowledge of new tests that are developed—and no desire to learn about them. A new test for TB has been developed. It is clearly written in the test
new tests that are developed—and no desire to learn about them. A new test for TB has been developed. It is clearly written in the test information that it cannot be performed on blood, but only on abdominal and lung fluids. Nevertheless, certain doctors give instructions to perform this test on blood samples. As pathologists, we don't try to enlighten the doctors on such issues, because then their pride is hurt, and then they stop sending us samples.' A gynaecologist based in a metropolitan city added, 'For pregnant women who are in good health, they incessantly keep prescribing heamograms, kidney function tests and liver function tests.' Dr Pratibha Kulkarni, a gynaecologist from Pune, gave an instance of when a twenty-two-year-old woman came to her for infertility treatment. 'All investigations were already done. Actually all that was needed was to carry out some basic investigations to verify that there was no big problem. One has to explain to the woman that she should just wait for six to eight months. But all investigations are carried out anyway.
'One woman had an abortion in a big hospital in the month of December because she did not want a child just yet. And then she came to me in April complaining that she could not become pregnant and asking for treatment despite the fact that in the previous month, March, all investigations for infertility had been performed in a big hospital, and she had successfully become pregnant as recently as three months ago. What investigations and treatments could be more unscientific?'
Dr Jana, from Shahid Hospital, Chhattisgarh, explained how unscrupulous doctors cheated patients by advising unnecessary tests. 'First they show that the patient has contracted malaria. They show that by a lab test, and give treatment, but the patient does not get better. Then they do another test and show that the patient has typhoid. Doctors are given whatever reports they want by some labs, on payment of a commission. 'The investigations that are made are also often unnecessary. They are not indicated in the textbooks, but they have been euphemistically termed "routine investigations" just to increase the number of investigations required. '
Endorsing this view, Dr Arjun Rajagopalan, a surgeon from Chennai, said, 'It is a rare patient who gets away with just one or two investigations. All the patients I see hold a list of unnecessary tests.'
A pathologist from a metropolitan city revealed how many unnecessary investigations are advised. 'Take typhoid, for example. If the blood test is performed before the fifth day, it does not reveal anything. But it is carried out every alternate day from the first day onwards. The more expensive a test, the more it is prescribed. A sputum examination is generally sufficient to diagnose tuberculosis in the lungs. But the simple reality is that no test can detect it when the tuberculosis is elsewhere in the body—in the stomach, bones, or lymph nodes. But expensive tests like TB Gold and TB Platinum are prescribed. The more expensive the test, the more the commission.' The pathologist explained the phenomena of 'sink tests': 'This means the sample is just thrown into the sink without testing. The doctor prescribes tests, which by mutual understanding are not actually carried out by the pathologist, who collects the money for the test, and without testing he merely gives a "normal" report. Just one more way of increasing the commission. Many doctors have inadequate knowledge of new tests that are developed—and no desire to learn about them. A new test for TB has been developed. It is clearly written in the test
new tests that are developed—and no desire to learn about them. A new test for TB has been developed. It is clearly written in the test information that it cannot be performed on blood, but only on abdominal and lung fluids. Nevertheless, certain doctors give instructions to perform this test on blood samples. As pathologists, we don't try to enlighten the doctors on such issues, because then their pride is hurt, and then they stop sending us samples.' A gynaecologist based in a metropolitan city added, 'For pregnant women who are in good health, they incessantly keep prescribing heamograms, kidney function tests and liver function tests.' Dr Pratibha Kulkarni, a gynaecologist from Pune, gave an instance of when a twenty-two-year-old woman came to her for infertility treatment. 'All investigations were already done. Actually all that was needed was to carry out some basic investigations to verify that there was no big problem. One has to explain to the woman that she should just wait for six to eight months. But all investigations are carried out anyway.
'One woman had an abortion in a big hospital in the month of December because she did not want a child just yet. And then she came to me in April complaining that she could not become pregnant and asking for treatment despite the fact that in the previous month, March, all investigations for infertility had been performed in a big hospital, and she had successfully become pregnant as recently as three months ago. What investigations and treatments could be more unscientific?'
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