As many as 35% citizens do not trust the pathology lab they use, while majority want the government to cancel licenses of these labs if they are found giving incentives to doctors, says a survey report from LocalCircles.
As per the survey, 66% of respondent say their doctor has suggested a specific pathology lab for getting medical tests done while 34% have received wrong pathology reports.
LocalCircles conducted a 6-point survey which received more than 48,000 responses from across the country.
“Wrong test results given to patients because of vested interests can have serious health repercussions and citizens are keen that central and state governments take urgent action to form laws that help break the doctor-path lab commission nexus.
With the Consumer Protection Act 2019 in place, citizens are demanding that rules for consumer protection in healthcare be made a top priority. Another recommendation made by some consumers is standardization of prices and price bands for various tests and mandatory displays of such prices to consumers beforehand. Per some consumers, standardization of healthcare services and billing should be undertaken by the Bureau of Indian Standards as an exercise as well,” LocalCircles says.
Many small pathology labs have mushroomed across the country in the last decade and now we receive flyers of neighborhood labs with the newspaper. Citizens over the last 24 months have been raising the need for better regulation of pathology labs on LocalCircles.
After the consumer protection act 2019 was cleared in the parliament, LocalCircles says, consumers have been requesting that rules be made around consumer protection in the healthcare sector and within healthcare, functioning of pathology labs has been a top area of citizen concern, just after functioning of hospitals.
Clinical Establishment Act (CEA) 2010 emphasizes on minimum infrastructure that pathology labs should have but it has still not been adopted by many states. The central government should make sure that CEA 2010 is adopted by all states immediately and pathology labs are regulated under it.
Also, as per the available statistics, only around 1,000 of the existing 100,000+ operational labs in India are National Accreditation Board for Testing and Calibration Laboratories (NABL) accredited and most laboratories are functioning illegally, often providing suspicious or incorrect reports to thousands of patients.
For majority, their primary modus operandi to generate steady stream of business is to give commissions to doctors on their references. According to people, a ‘no doctor incentive’ should be made a mandatory requirement for any lab to get a NABL certification.
The first question asked citizens how much they trust the pathology lab that they generally use for getting medical tests done. Only 17% said they fully trust them while 48% said they had a high level of trust in them but they still stay vigilant.About 28% said they had a low level of trust and therefore they stay vigilant while 7% said they had very low or no trust in them.
‘Sink tests’ have become quite common nowadays where a lab takes your sample only to throw it in a sink and generate a false report, causing much distress among the patients.
The next question asked if the doctors they have visited for themselves of their family over the last one year tended to suggest that they use a specific pathology lab for getting medical tests done. 33% said most of the doctors did it while 33% said some of them did it. Only 29% said none of the doctors indulged in this behaviour.
Consumers have also reported that their doctors force them to get the tests done from a specific lab in their area saying it is better than others or that they would send reports directly to them.
When asked how many cases have they had in the past three years where the pathology reports for them of their family member was wrong. Around 34% said it had never happened with them while 30% said it had happened up to three times.
About 4% said it had happened with them more than three times and 32% of respondents were unsure about it.
Many consumers had reported that their doctor asks them to get general tests like blood count, urine test, liver function test (LFT) and kidney function test (KFT) done quite often, even if there might not have been a need for it.
Next question asked how many times in the last three years did they feel that their doctor ordered more tests than were actually necessary. About 35% said never, 31% said one to three times, 19% said more than three times and 15% said they were unsure.
Recently, an audio clip of a doctor talking to a pathology lab representative went viral on social media, where they were talking about the commission on prescribed tests and generating false reports.
The penultimate question asked if pathology labs should lose their certification license if found incentivizing or commissioning doctors to prescribe medical tests. Majority or 92% said ‘yes’ while only 2% said ‘no’.
Many of us have heard stories of how the remuneration of doctors in hospitals is linked to the amount of business they get for the hospital. This leads to doctors prescribing unnecessary tests and keeping the patients in hospitals for a longer time than actually required.
Around 89% citizens in the final question said that doctor’s earning in a hospital should not be related to the tests they refer to its lab. Only 9% said this should not be the case.
All in all, the survey here highlights the mistrust that citizens have with pathology labs and how according to people there is a strong need to address the Doctor-Pathology lab nexus on the ground through the formation of clear consumer protection rules and then driving enforcement of these rules via the local health and consumer departments.
LocalCircles says it will be writing to the various stakeholder departments of the government urging them to act.
