YOU PAY THE HOSPITAL ₹100. YOUR DOCTOR MAY GET ₹10.
BUT IF SOMETHING GOES WRONG?
100% OF THE ANGER COMES TO THE DOCTOR.
Most patients have absolutely no idea how strange hospital medicine has become.
Look at what is happening in Mumbai right now.
Dr Asiya Khan Luqman joined Saifee Hospital in February as a first-year DNB General Surgery trainee.
She has alleged excessive duty hours, ragging, mental harassment and problems with her training.
Saifee says those allegations are false.
The hospital has, in turn, alleged problems with attendance, conduct and clinical responsibilities.
She was suspended.
The dispute exploded onto social media.
And Saifee Hospital Trust has now filed a:
₹125 CRORE DEFAMATION SUIT.
The Bombay High Court is dealing with it.
I have personally worked at Saifee Hospital.
So I am NOT going to declare Asiya right.
I am NOT going to declare Saifee wrong.
That would be irresponsible.
But the story exposes something much bigger.
Patients see the white coat.
They rarely see the CONTRACT behind it.
And that contract can completely change what being a “hospital doctor” actually means.
Many senior doctors in private hospitals are not employees at all.
They are CONSULTANTS.
The hospital may own the building.
Employ the nurses.
Set the room tariff.
Run the operating theatre.
Control the billing system.
Create packages.
Negotiate with insurers.
Set administrative protocols.
And sometimes impose commercial expectations.
But the doctor may still be legally structured as an independent professional.
Some consultancy agreements even contain indemnity provisions designed to push responsibility back towards the consultant.
That does NOT magically make a hospital immune from liability to patients.
But imagine the doctor's position.
The institution controls enormous parts of the machine.
Your name sits on the prescription.
Then come the economics.
Government data analysing private hospitalisation have shown the doctor/surgeon fee to be only a fraction of the patient's total expenditure.
Court records also contain consultant arrangements where the professional fee itself was split between doctor and hospital.
So when I say:
YOU PAID ₹100.
THE DOCTOR MAY HAVE RECEIVED ₹10.
I am not claiming this happens in every hospital.
It does not.
I am saying something patients need to understand:
THE HOSPITAL BILL IS NOT THE DOCTOR'S INCOME.
Not remotely.
Yet listen to what happens afterwards.
Expensive bill?
“Greedy doctor.”
Lots of investigations?
“Doctor gets commission.”
Admission advised?
“Money making.”
Operation advised?
“Commercial.”
Complication?
“Doctor destroyed my life.”
Death?
“DOCTOR NE MAAR DIYA.”
The machinery disappears.
Only one human face remains.
THE DOCTOR.
And the loss of control begins much earlier than consultant practice.
Young doctors spend years training inside hierarchies in which they may have very little bargaining power.
Long duty hours.
Stipends.
Residency rules.
Training requirements.
Service bonds.
Across India, depending upon the state and programme, doctors can be required to serve for years in government, rural, remote or difficult postings after training.
Private hospital research from Maharashtra has also documented service bonds, heavy workloads, relatively low junior pay and doctors describing themselves as having little control over employment conditions.
Then, after all that training, the doctor finally becomes a consultant.
Freedom?
Not necessarily.
Now come contracts.
Revenue sharing.
Minimum guarantees.
Performance reviews.
And, in some hospital environments documented in Maharashtra research, even revenue or patient-conversion targets.
Think about the absurdity.
The patient imagines:
“This doctor controls everything.”
The doctor may be thinking:
“I do not even control the price printed on your bill.”
But doctors, before we turn ourselves into victims:
STOP.
The system may pressure you.
It does not own your ethics.
If somebody encourages an unnecessary investigation, YOUR signature remains yours.
If revenue pressure changes an indication, YOUR conscience remains yours.
If a patient should not undergo surgery, the correct answer remains:
NO.
Pressure explains behaviour.
IT DOES NOT EXCUSE IT.
And yes, unethical doctors exist.
Cuts exist.
Perverse incentives exist.
Commercial medicine exists.
Pretending otherwise would insult patients.
But pretending every ₹5 lakh hospital bill went into your surgeon's pocket is equally absurd.
This is precisely why we started the Dear People Movement and wrote “Dear People, With Love and Care, Your Doctors” and “Doctors Are Not Murderers.”
Patients need to understand the system their doctor works inside.
Doctors need to accept responsibility for the decisions that remain theirs.
So the next time you receive an enormous hospital bill, ask questions.
Absolutely.
But before automatically calling your doctor greedy, ask:
WHO SET THE PRICE?
WHO DESIGNED THE PACKAGE?
WHO OWNS THE SYSTEM?
And doctors, ask yourselves the equally uncomfortable question:
WHO SIGNED THE PRESCRIPTION?
Because modern healthcare has created a remarkable arrangement.
THE HOSPITAL CAN BE THE MACHINE.
THE DOCTOR CAN BE ONE SMALL PART OF IT.
BUT WHEN THE MACHINE FAILS...
THE DOCTOR BECOMES THE ENTIRE STORY.
What are your thoughts on the healthcare system? Leave a comment.
- Dr. Debraj Shome,
Author of
'DOCTORS ARE NOT MURDERERS'
&
'DEAR PEOPLE, WITH LOVE AND CARE, YOUR DOCTORS'.
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