Cataract

Inappropriate cataract surgery: is it a myth or reality ?

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There have been media reports in which the doctors and the hospitals have been accused of performing cataract surgeries when these are not actually required. The question is, are these really fake news or are actually happening?

Media reports a recent media report, attributed rapid rise in the number of certain type surgeries being done at various hospitals , to the fact that some of these surgeries are been done for economic reasons only. The patient may not have actually needed one. Among the many surgical procedure, the cataract was reported to be the commonest.

Targets to meet: News report say that in corporate hospitals, the doctors are pressurized to perform more surgeries to increase the corporate profits as surgeries offer greater financial return in shorter time. Consequently some of the patients are advised to undergo cataract surgery in spite of the fact the patient can manage without it. It further suggested that those who are advised to undergo surgery should better have a second opinion, which is very much concerning. Similar concern are also been reported from advanced counties as well.

The Optometric-Ophthalmic Kickback Scheme: Dr Robert P. Gervais reported the arrangement of kick back system practiced in US, in which patients are predominantly operated to make money, by ophthalmologist in cooperation with optometrist. It is surprising that it is practiced in a country like US where documentation and other regulations are so diligent followed. The scenario could be much worse in India where it is difficult to enforce government regulations.

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Scientific reports: a number of scientific publications have reported the documentation of performing unnecessary surgeries to be as high as 30 percent for certain type of surgeries. Practices of unnecessary surgical procedures in Indian scenario are been well documented in case of caesarean deliveries and hysterectomies under government insurance schemes .

Government stand: a senior government minister have expressed concern on this issue and share the perception that kick back, cut and commission is prevalent in some segment of practice. They have also ” considering to bring some type of oversight for pathological laboratories and diagnostic centers to end the corrupt practices including possible nexus between doctors and the laboratories, and cartelization among diagnostic centers

Doctors and representative medical bodies: They largely dismissed the concerns over profit-driven tests and procedures as a “perception,” saying corruption is less widespread than the media would have it appear. “The medical profession is noble and will remain noble,” “There are people who are corrupt, they are facing charges and they are being punished.”

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Conclusion: Though the actual figures may actually be debated as what percentage of doctors are indulging in these kind of practices but these reports certainly points to the maligning of reputation of whole profession. These will only add to stricter government regulation and legal scrutiny of clinical practice and practitioners.

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