Doctors accused of taking bribes

Excerpt from "Montreal doctors accused of taking bribes," CBC News. February 21, 2012--Two Montreal cardiologists are facing disciplinary action over allegations they received hefty kickbacks to push patients to the top of the waiting list, the Quebec College of Physicians says. The college's investigation uncovered at least two doctors who were allegedly taking envelopes of cash in exchange for providing faster service, Dr. Charles Bernard told CBC News.

The investigation was triggered 14 months ago, when a Montreal woman told the news media she had paid a $2,000 cash "incentive" to have her mother bumped to the top of a waiting list. After the investigation, the college said two cardiologists from Montreal would face a disciplinary hearing later this year in connection with such incidents. Bernard would not discuss the details of the cases, as nothing yet has been proved.

Dr. Gaetan Barrette, the head of Quebec's federation of specialist doctors, said he hoped the college would send a clear message that the alleged behavior is unacceptable. "It's disgusting for the medical profession," he told CBC News. "There are no other reasons I can think of other than greed for those doctors to go in that direction." Barrette said the two cardiologists could be suspended, but it is unlikely they will be prohibited from practicing permanently. A sanction that harsh is typically reserved for extreme cases, such as sexual assault of a patient, he said. Jean-Pierre Ménard, a lawyer who specializes in health law and patients’ rights, said there is little incentive for those who know about these practices to bring them to light. "When the patient is offering cash to the doctor, and the doctor is accepting the cash … both of them have an interest not to tell the story," he told CBC News.

CMDA CEO David Stevens, MD, MA (Ethics): "Bribery is possible when those entrusted with power use it for personal gain.

"Medical bribery is now common around the world. Mahajan V. relates that patients in India have to pay bribes to get the bodies of their dead relatives released from the hospital mortuary.¹ Transparency International reports that surveys showed 95 percent of Pakistanis think the health system is corrupt and 96 percent of people had paid a healthcare provider (they don’t merit the term 'professional') a bribe.² I know first-hand stories of patients routinely bribing doctors in Russia to get even basic services. The Chronicle of Higher Education in July documents the corruption in medical services that is literally killing Russia. Students bribe their way into medical school and then bribe their professors for their grades.³

"The China Daily wrote last month of the 'commercial bribery in the country's hospitals and medical institutions' and the demands made on the government to curb it.⁴ The 'five biggest public hospitals in Hanoi banned their staff from taking ‘envelope’ (tip or black money) from patients in September 2011.' These tips are a common practice to avoid getting a 'chilly response' from healthcare providers.

"I don’t know if the doctors accused in Canada are guilty or whether corruption is widespread in the Canadian health system. I do know the conditions that lead healthcare professionals to break their covenant with patients. Corruption thrives when personnel are underpaid and overworked, and when resources considered very valuable are limited or rationed. We are rapidly moving down that path in the U.S. Like a cancer, corruption starts small but rapidly grows until it becomes endemic in these conditions.

"The best defense against corruption is the character and integrity of the individual physician or dentist. Simply teaching ethics does not produce trustworthy doctors; character development begins long before medical and dental school. That's why it is so important to screen for character as well as intellect when interviewing prospective students. Upright students must then learn, through worthy mentors and courses emphasizing ethics, what it means to be a true and trustworthy professional.

"If not, we may all have to pay bribes in the not so distant future to get the healthcare we need."
___________________________________

1. Mahajan V. White coated corruption. Indian J Med Ethics 2010; 7: 18-20. Available from URL: http://www.ijme.in/191le62.html.
2. Transparency International. Corruption in public services; perceived corruption in health sector. Berlin, Germany: Transparency International, 2002.
3. http://chronicle.com/article/Corruption-in-Russian-Medical/128200/
4. http://www.chinadaily.com.cn/business/2012-02/18/content_14639485.htm
5. http://www.eyedrd.org/2011/12/the-ethics-of-medical-bribery-money-envelope-in-vietnam.html

CMDA Ethics Statement: Health Care Delivery
CMDA Ethics Statement: Principles of Christian Excellence in Medical & Dental Practice
CMDA Ethics Statement: Christian Physician's Oath