Home Forums Other Specialities General Topics Kickback for Referring Patients

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      Anonymous
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      Dr. Aniruddha Malpani, Medical Director at Malpani Infertility Clinic writes in Docplexus:

      I received a call from a doctor who said he’d be happy to refer patients to my IVF clinic provided I was willing to give him a referral fee for doing so. This is something I’ve always been very unhappy about, because I think of a referral fee as being a commission being paid to a middleman. It adds to the patient’s cost, because I’m going to then add this fee to my charges, which means that it’s ultimately the poor patient who ends up paying for this.

      I also hate the lack of transparency and openness this involves. My concern is that if I need to incentivize someone to send patients to me, this is going to create a lot of tension in the relationship between my patient and me. I’d much rather have a direct relationship where the patient comes directly to me, either through word of mouth , because she’s referred by another patient, or perhaps through our website. This direct one on one engagement allows me to build a trusting relationship because there is no middleman involved, and there’s no one other than my patient who I am answerable to.

      Having said this, I sometimes wonder whether I’m taking a holier-than-thou attitude. Most doctors ( and hospitals) treat these referral fees as the cost of doing business. They are cleverly disguised , by being called “medical management fees”. They justify this by pointing out that other industries ( for example, hotels and insurance) pay referral fees and commissions all the time. If they do so, then is it really wrong for a doctor to do this? After all, if I am a good doctor then how does it matter whether I pay a commission or not to someone for sending a patient to me?

      Apart from the fact that paying a referral fee is unethical , what makes me more uncomfortable is that it’s done under the table. These are cash transactions, which are not accounted for, and this black money tarnishes the reputation of the medical profession.

      What concerns me even more is that this entire referral business is becoming institutionalised. Online Digital medical platforms and marketplaces are corporates and they do charge doctors a referral fee very cleverly for directing patients to selected doctor, by disguising this as a listing fee. A rose is a rose, by whichever name one may call it, and this practise of paying for acquiring patients is going to increase by leaps and bounds, causing harm to both doctors and patients as the digital middleman will take his pound of flesh.

      Dr. Aniruddha Malpani runs an Infertility Clinic in Mumbai

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