Nothing Surprises People In Kenya Anymore...

Dr Onyango(not his real name as mentioned earlier) a senior radiologist in KNH, recollects the events of the month of November last year when he referred his patient to what he believed to be a reputable health center in Chennai, India, he did not expect anything except a consultation report and, hopefully, news of a good outcome. Instead, the first communication the honest daktari received from the lead consultant from Apollo hospital was an e-mail requesting his banking details.
When he inquired why they needed his bank details, the Indian consultant informed him that they often paid ‘consultation fees/benefits’ to the referring doctor. He declined the offer and told the Indian doctor that such dealings were unethical. Since then he has never sent any more patients to the institution.
With research, Dr Onyango would later learn of the vast criminal racket in the medical services that had enriched many doctors in Kenya and India, where kickbacks to referring doctors are normal practice. They call it “Cut-practice.” Dr Onyango, says the practice is at its mind-boggling levels in India. Many Indian medical specialists and hospitals offer cash incentives to Indian primary care doctors to send them referrals. The cut-practice is so competitive that commissions are reported to be as high as 40-60 percent of the consultation fee. There are even reports of Indian specialists literally going to primary care doctors’ clinics, cash-stuffed envelopes in hand, to solicit referrals.

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Back to the international version of the scam(read Kenya-India); It’s orchestrated by Indian business coordinators, the vast majority of whom are not medically trained. Over the years, several of them have set up health tourism companies in Nairobi and have established unethical partnerships with Kenyan doctors to operate a rather straight forward scam. The Indian businessmen, together with their Kenyan partners, network with Kenyan doctors, offering them promises of commissions on each patient referred.
Patients that could be effectively and successfully treated or operated on in KNH, for instance, get referred to India. Whereas patients and their relatives often initiate the request for a referral, the doctor in the racket does not try to persuade the patient to get the treatment locally. He is very happy to facilitate a trip to India.
The doctor prepares a referral letter that he sends by e-mail to the Indian business coordinator – usually a non-medical person. The latter forwards the mail to a doctor in India, a member of a given chain of hospitals. The patient is accepted, the Nairobi doctor is advised, and he/she relays the news to his/her patient.
The patient, armed with a letter by his/her doctor, seeks a visa from the Indian High Commission. The diplomats are very delighted to assist and a visa is granted. An Emirates air ticket is purchased and the patient, together with a relative, travels to India. He/She pays his/her fees on admission, a percentage of which is immediately sent to his/her Nairobi doctor’s bank account. He/she then receives the same treatment that was available back home.
Dr Onyango recounts that the more tragic are the cases of patients with very advanced diseases, such as terminal stage, inoperable cancers. After review and investigation in Kenya, a patient is informed that she has, say, pancreatic cancer that has spread all over the body. This is one of the most aggressive cancers, with poor outcome even in the best centers in the world. Like most human beings, the patient wants “everything done.” Money is mobilized, and her doctor activates the Cut-practice system.
When the terminally ill patient arrives in India, her Kenyan doctor gets his big kick-back from the fees. The patient embarks on chemotherapy. His/her condition deteriorates. He/she dies within two weeks of arrival in India. His/Her family is devastated, but they are comforted by the knowledge that “everything humanly possible was done.” The cost of returning the body is five times that of a living person’s air travel.
It’s over to the next prey by racket!

This world is not our home

Wewe uliyesoma leta samaly

Referral is a very delicate process. When you refer a patient (or even in some cases of transfer of care), it is usually for the benefit and/or convenience of the patient. BUT, care at a referral level is often more expensive so one wants to avoid referring a patient unnecessarily. AND, keeping a patient whose care is beyond your level of specialization (hoarding) is poor standard of care. Kickbacks in medicine exist and it is not unethical. What is unethical is demanding for it. When practitioners share income from referrals with the referrer, it lowers referral threshold, (and therefore improves overall care), and it reduces hoarding. A practitioner who refers a patient should have no difficulties accepting a kickback if the referral is justified. But he should not demand for the kickback.

In short,ma doktari na wezi hawana tofauti its either your money or your life…choosing wisely

:smiley: You cannot offer care for free

we will all die at some point including the trickster doctors, uko mbele wallahi tunamenyana nao vilivyo!!