Fleecing Doctors In Colombo
By Dr. Harold Gunatillake
You are paying too much money to these Sri Lankan doctors, dear, how about my money for shopping?
An email circulating from a retired expat doctor from UK is raising eyebrows of many locals and expats, in paradise and abroad. It is causing some degree of scarring to the well-respected Sri Lankan specialists, detrimental to their profession, and bringing in a lot of negative feelings for the medical practitioners in paradise. Let us go into more details about this email, sent by a retired expatriate MBBS doctor, not satisfied with the way he was treated, mainly the professional side.
The email heads: Private hospitals – for better or for worse?
“I am a retired doctor. I went to a private hospital in Colombo for a general check-up. It cost me nearly Rs 4000.
An MBBS doctor looked at my chest x-ray and said I have a shadow in the left lung and asked me to get a Filarial blood test done and also referred me to a Cardiologist to get an Echo –cardiogram done.
This cost me another Rs 2800.
The Cardiologist did the Echo-Cardiogram and said my heart is normal. He never looked at my ECG or X-ray.
When I asked him about the lung shadow he said I can go to “Dr.So and So” at Durdans and that he dealt with only the heart. I was too shocked to speak.
He said he could do a Treadmill Test, which again tests the heart. When I asked the doctor how much it cost he said Rs 2800.
The irony is that he had already said that my heart was normal.
This doctor would have got part of the money if I got this test done.
I am not sure whether he realized I was a doctor or he thought I was a fool.
They are so greedy. I cannot imagine how they must be taking money from lay people.
I told the Cardiologist point blank that they knew how to fleece people and left without getting the Treadmill Test (which I did not need) done.
Thank you for reading this letter. I will never go to this private hospital situated in Colombo 3 again.
It is such a shameless place.
We were taught at Medical School to treat the whole patient and not to treat them organ by organ
like they do at some of the private hospitals”.
By Raja Retired doctor.
My comments
It appears to me that this retired doctor who came for a holiday in Sri Lanka, wanted to hit two birds with one stone, by having a cheap medical check-up, which is not available in the public NHS scheme in the UK, and privately, the price would be too exorbitant and may be unaffordable…
This seems to be the normal trend, for expatriates visiting the island for a holiday; the ladies shopping around in “House of Fashion” queued up for long hours and sweating, with make-up melting or at Odel’s in Union Place, having, maybe an affluent lifestyle in the domiciled havens like United Kingdom, America, Canada, and Australia, among other countries, visiting paradise to have a ‘ball’ and also getting the satisfaction of having a ‘medical’ from the local medical profession. The client would boast after a visit to a local specialist, “Yes, the specialist said my blood pressure is too high, but okay for my age”. The latter part of the doctor’s wisdom, makes the client happy, like most going to Kataragama to get the blessings of “Kataragama Deviyo”.
Mind you readers, this doctor did not visit the cardiologist for a diagnosis of any illness, but a random check-up for mental relief, for fear of approaching closer to the ‘Home’, meaning hell or heaven.
The retired expat doctor is now a bit concerned about doling out Rs 4000, (a tip in London for a waiter is 5 sterling pounds, equivalent to approximately Rs 1,000). In paradise he has paid peanuts, for an examination by a GP, resting ECG and a chest X ray. Possibly, the doctor may be having a private ‘BUPA’ health insurance cover to claim, as if he has suffered a dreadful disease in the tropic.
The cardiologist quite ethically claimed that he looks after the heart and for the chest he may have to see a chest physician at Durdan’s. The heart doctor was prepared to do a stress cardiograph for Rs. 2,800, which are again peanuts for the ex-pat doctor. The cardiologist quite rightly recommended the treadmill ECG which more diagnostically detects any heart strain. The resting ECG may even give a normal healthy picture of a false situation, and you may drop dead a few minutes later. This is my personal experience with some of my clients. The readers should know that the specialist is by your side for 10 minutes, monitoring the ECG tracing for “ST segment” changes, recording pulse and blood pressure intermittently. And all that for a ‘peanut price’.
Of course, whilst the doctor is getting the medical check-up invariable the wife and family, would be spending sterling pounds at the fashion houses, as the clothes are much cheaper than at ‘Marks & Spence’, and the choice is unbelievable in paradise shops.
These expats could buy all the traditional foods, like indiappans, rottie, hoppers, lamprai, and all that in UK, but the free meals they enjoy with local loved ones, makes them feel that they have ‘had a ball’ in paradise, whilst the host or hosts are struggling here to pay their electricity bill. These expats are given the best of affordable hospitality including free transport from and to Katunayake airport. Why do they come and complain about the alleged fleecing doctors when they pay peanuts in paradise, have a glorious memorable holiday, to return again, in a year?
“May the Triple Gem guard them”, if these expats are Buddhists, or if they worship a God, may the Lord bless them!
By the way the complainant lives in up-market Surrey.
An annual physical, which I believe is not normally available (at least to the extent this doctor wished it to be done) would probably have cost him most of his savings in “Great” Britain or most other Western countries save those perhaps in Scandinavia. The similiar checkup costs a pittance in Sri Lanka when exchange rates are factored in, accompanied by the added bonus of the opinions of quallified doctors from all over the world
This guy is certainly living in the past – Probably expects this ‘paan-baage’ to cost Rs. 1.50 as well !!!
Sri Lanka has suceeded in delivering a public/private healthcare system that is enviable in any country of similar economic stature. Most Western countries wont even see you in a hospital unless you are at death’s door… and don’t even offer the choice of a private system (or indded sometimes, not even a public one)
the concept was not only the fees but associated blunders by these hospital doctors, comoparing the rate in strelings is stupidity while the fees should be compared with GDP or af an average srilankan’s income. After all these hospitals in srilanka charge mucu much high for consulatation sometime 1,250.00 per session. If any nurt argues that is cheaper than in Lndon he should be sent to mental asylum.
Well, there are two sides to a story and both sides are well expressed. However, the need for the “family doctor” concept is emerging more than ever before.
As kids, we were treated by our family doctor who had time for us, while being fully aware of our health profile. If he felt he could not handle the situation we were given a reference letter to a “specialist”. Once consulted, the specialist acted in a suitable manner where we were either hospitalized for treatment, investigated for diagnosis and/or were referred back with a sealed envelope with a diagnosis and way forward.. We were quite happy to be back to our GP who took great care of us, while we had a great respect to the consultant who provided his opinion/treatment to helped us feel better. I think the consumer has the choice here to revert back to this system, and leave the consultants with complicated issues rather than wasting their valuable time with simple issues. It is we consumers who made the mistake by taking decisions we were not qualified to take. We basically wanted to do one better than the JONSES !
Indira’s comment is a hundred percent correct. The family Doctor or GP concept is fast dying away. Those were the good old days where a family relied on their GP for treatment, advice and even counselling. The trend has changed with people flocking to Specialists even for a trivial headache. GP’s are also hesitant to refer Patients to present day Specialists as do not have any ethics to refer the Patient back to his or her GP , unlike in foreign Countries. In effect, if a GP refers 3 Patients to a Specialist Physician, the GP can be rest assured that he will lose all 3 Patients for good as the Physician will make sure that these Patients continue with him. Our public should at least from now, learn to value and appreciate that a Family GP is for life as, for the GP, its the family that comes first and then only the money.
While agreeing with the Authors note and most of the comments above , I must mention, due to the prevailing economic Situation ,certain Consultants have turned to Money Sharks . I remember a lady who has slipped and fallen and fractured her leg being referred to to a retired JMO , as she was a tourist.When a Tourist gets injured , you have to go through a certain Doctor , who directs the patient ,to various Consultants at his whim.
Also, mind you, entering a private Hospital for a serious complaint or a Surgery is a Nightmare . they are not properly managed nor monitored as the Doctor on call is either a retired , Medical Student or may be a foreign graduate. In any case , their knowledge in even some basic managements is generally below par. Any way even if some thing is wrong , the Dr can’t do any thing ,without the instructions of the Consultant in charge who are usually not available.as opposed to Govt Hospitals where a Consultant is available round the clock.. As a person with considerable experience , I have seen so many Tragedies ,occurring . Now I see this creeping in to peripheral Govt Hospitals as well . In Medicine one must be always in an environment of upgraded Clinical touch . This is why foreign countries have CPD . Most of our people are also happier to say that they went to this Pvt Hospital and spent half Million Rupees.
As compared to older generations who dedicated their efforts towards patients, I see the attitudes of most of the new generations are hellbent on making Money or doing Post Grad studies or try to go abroad . Patients welfare becomes last priority.Iam sure all of you have stories to add.to this effect . We do have a Health Minister who cares. . But the whole system needs a big overhaul.
You are quite right Indira.We need to bring that family doctor culture again to avoid this ”specialist” mania. I know some people run for specialists even for coughs and colds.
Who are the JONESES in this case? Can you please explain how Sri Lankas method of providing medical services can be equated to “keeping up with the Joneses” ?
Channelling is simply a perversion of the “Family Doctor” principle – expanded to factory-process as many patients as possible within a given time-frame.
Never mind the Joneses and the expats, But I am not sure if you are aware theat almost 75% of Sri Lankans I mean who live in SriLanka cant afford such fancy costs. Man you are way too off the mark.Do you know or have you seen the long lines in private hospitals in Colombo, Have you heard of people coming from far off places taking the the early morning bus with the sick and……. And the best part in most of the Docs had free education on the poor man dime,,,
The Sri Lankan PRIVATE medical service costs maybe peanuts for a expat of this nature,but for many Lankans having to go to a pvt.hospital to seek treatment happens to be a economical nightmare,its like a taxi meter, pvt medical service is a big time enterprise in paradise a rip off no mercy.
A very good article!! We only need tourists expats or otherwise to come and spend their money in SL. We don’t want to give anything back.
There is no other country like SL for anyone to spend their holiday. The rest of the world should be lucky to have Sri Lanka on Earth.
Welldone!!
Get the Tourist board to advertise the message!!
This is a shame for all expats.I too work as a doctor abroad and get all my dental work and other minor medical issues sorted when I visit Lanka.Rs 4000 for a general checkup and easpecially the Rs 2800 for an Cardiac Echo (About 25 Dollars) is absolute peanuts when compared to the prices in western countries, and Im shocked that this individual (expat)is complaining about it. Maybe the last time he left Sri Lanka the price of bread was 10 cents and he expected everything to be the same.
Dude the point is he was ripped off, you are comparing it with the UK expenses, are you a bloudy fool
The retired doctor is quite right. He is only pointing out, by his own experience, that private doctors in SL are greedy.
The fact that he lives abroad is irrelevant. The comments about him shopping at Marks and Spence (sic) etc are all irrelevant. The writer appears to be envious.
If a Sri Lankan citizen living in Sri Lanka sent the same email the response would have been complete agreement! It’s sheer jealousy, that’s all.
.
Well there are few doubts in this article needs further explanation.First of all why that medical officer sent this retired doctor to a Cardiologist. After all what he has detected was a lung shadow which needed the attention of a lung physician or a general physician for that matter. If he was suspicious of Filaria he could have requested few more blood tests to confirm of dispute the diagnosis.
Did he refer him to a cardiologist because the patient had untold cardiac ailments , not clear from the email or the article.
What the cardiologist has done is also debatable.He has just seen the report without assessing the patient and I fully agree with the idea of ”holistic approach” in patient care rather than treating reports.There could not have been an option of tread mill test as a patient cannot decide whether he needs one or not. If the cardiologist didn’t bother to see the ECG how he could have suggested a tread mill test is a big surprise.
Dr Gunatileke is trying to safeguard the doctors and as a doctor I don’t think that is the right thing to do. Our patients are very vulnerable whether they come from overseas or not. These private hospitals are not governed strictly and the doctors have enormous say in what they are doing. There is no accepted guidence when it comes to patient care. I am glad this email was circulated as it will open the eyes of some at least and the public will be more mindful. Unless public exert pressure on these issues nothing will be changed .”THE BASIC NEED IS GOOD ETHICAL PATIENT CARE”.
Whether the patient come from overseas or not or whether it is cheaper here compared to developed countries or not are complete nonsense and totally irrelevant .
I am glad we have doctors who check your testicles only ( Ata dostara )
Our doctors are so good. They do not examine 50 patients giving only 3 minutes a patient after 5 p.m finishing their regular government hospital work.
Sure they have a place in heaven.
I think dr Raja is spot on , he is not complaining about the cost but about atititude! The responce seems to be “kohay the yanne mallay pol”!!!!
Please understand the mail. He is talking for the sake of laymen and how we doctors are inconveniencing and ripping them of them by referring and ordering tests which are not necessary and also the the trouble taken for this patient in getting diagnosed. I dont understand this anti-foreigner mentality in SriLanka!!! This is really ridiculous
With all due respects, Dr Harold Gunatilleke
One Medical Doctor has expressed what he thought was a grievience. Another Doctor castigate him dragging Indiyappan to melted make up at the queue of House of Fashion. What is your grievience Doctor? Were you the Doctor who would have looked at his lung patch or are you against expats buying Indiyappan and garments from House of Fashion?
May be the retired Doctor has no real sense of the cost of living in Sri Lanka for a reasons not known to you and me. But it is not unreasonable for him to raise some questions. The people in a position to answer him rationally could just do that.
It is true in developed countries medical consultations, investigations and procedures are very costly. So an expat Sri Lankan naturally would try to save a few pounds or dollars by getting some basic issues done during a visit to the home country. Some of the expats are not necessarily leading luxurious lives; some do live frm hand to mouth because of the cost of living they would have migrated for a variety of reasons.
The real problem today is that most of our Medical Professionals think of themselves no end, but they themselves go abroad for treatment! This show their level of knowledge and confidence on each other.
Dr Gunatilleke’s comment “The resting ECG may even give a normal healthy picture of a false situation, and you may drop dead a few minutes later. This is my personal experience with some of my clients.” is enlightening. So, how many clients dropped dead? Forgive me Doctor, I am not here to ridicule you, but I am just trying to show that ridiculing someone’s point is not the correct approach.
Now the important fact to discuss here is not the “peanut price” but whether the patients really get a proper treatment There was a time being a medical doctor was considered a nobel vocation; it is no longer a vocation to many (some are now called ‘mas kada mudalali’ – butcher) and similarly its nobility has gone down the drain. I must say that I have known many Doctors who were really noble, but the vast majority today do not qualify for that.
The fault may not be with the Doctors. May be we are the fools who boost their ego and fatten their pockets thus driving them to become greedier by the day. Our medical set up can be and should be improved. Our Doctors should learn to be back on earth rather than chasing money all the time. Our man on the street should learn how best he should go about getting a ‘lung patch’ checked…
And finally, all ECG machines should be designated for funeral parlours use, lest patients drop dead a few minutes later.
Many actions of the MBBS from uk has done make no sense. Firstly he must well know that a chest x ray needs to be reported by a radiologist and subsequently discussed with a chest physician. He may require a CT chest and/or a bronchoscopy for further evaluation. Going to a cardiologist in this case has to be viewed as an attempt to get a “cardiac clearance” and very correctly the cardiologist has offered a stress test and suggested that UK MBBS see a chest physician regarding the shadow on his X-ray. in the modern world of medicine where knowledge grows rapidly one person cannot be expected to be a specialist in all fields and even attempting this would be placing lives in danger.
Dear Dr Harold Gunatillake,
Poor medical ethics and professional misconduct could happen any country.One of the main function of Medical council is maintain professional integrity and maintain best practice, mainly look after well being of uneducated or lay man.
We have an impression, main function of medical council is to look after the well being or hide wrong doing of the doctors or just collect money for registration.
Can you tell me how many qualified doctors are de-registred in Srilanka.
Just look at list in UK or other western world medical council website.
(eg : http://www.ahpra.gov.au/)
Dont you see behaviour of our doctors in the hospital.I often asked our service is patient centred or doctor’s own interest based.
Poeple, often go holiday for countries where cheaper medical service available esp. for long waited surgeries and dental services.
Just dont think all expatriates are super-rich.I have a story of my own brothe rin law admitted in a popular hospital for septicaemia and kept longer in the ICU for minor indication such as hypokalaemia.Specialist refused to transfer him to normal ward.
Then , later we have to discharge him under medical advise .He was later admitted to another hospital to very normal ward.
Imagine a middle class family man admitted to a private hospital , leaving hospital after selling his property?
Just built ethics, make money in a proper way.
All of us going leave this world with nothing but only with deeds.
Dr Feroz
Sometime ago my mother was admitted to a private hospital for treatment in the ICU and later in the ward. Two of us visiting her were medical specialists practicing overseas. We watched with amazement at the number of specialists visiting her, each one receiving a referral from the other. There was no consultation with the family. With no accountability, it sure did appear to be “fleecing” as Dr Raja has rightly expressed. The GP should act as the gatekeeper and be the only one allowed to refer as what is happening now is totally unethical.
I am a doctor myself who worked in both SL and abroad. I am also planning to return to SL to serve the people – NOT to rip them off.
I tell you one incident which happened to me! When i was a medical student in Colombo, i took a patient to a well-known Neurosurgeon. He came 3 hours late – by this time, it was 9 PM. He took just a minute to ask 3-4 questions and did a biceps reflex. NOTHING else but asked for a EEG!
I just could not tell you how angry i was.
In SL, doctors exploit poor patients. How come patients pay Rs 2000 and then they receive a substandard care! You are not supposed to question the doctor. They hardly examine you. They write a long list of medicines you did NOT need in the first place! – including a multivitamin.
Recently, one of my friend who is a junior doctor told me that one physician writes prescription like this. If he is prescribing antibiotic amoxicillin, he will write brand A for morning dose and brand B for evening dose!
Another Director of a pharmaceutical company who happens to be a doctor himself told me two months ago that his father was admitted to ICU in a private hospital and then dialysed – both of which were NOT necessary in the first place.
As a doctor, i have to tell you, most of the patients probably get a bad deal in the private sector which is of course there to make money. But, we can still deliver the best ethical care while looking after financial gain.
Reality seems like money come first whether there is good care or not. Shame on doctors.
crooked doctors are popping up like mushrooms
they pay big money for these machines
they have to pay them off
some clowns who call themselves doctors
suggest a stress test even if you go to see him for a sprained ankle
these fuzz balls are fleecing innocent people
they are not doctors but frauds
we need an undercover team to expose the trash of our society
over to you siripala
I agree with Dr Raja, some of the medical profession in SL treat the ordinary people as if they were idiots, I am a Sri Lankan living in the UK and visit my family in SL every year, the stories they tell me about their encounters with the doctor confirms what Dr Raja said.
We were taught at Medical School to treat the whole patient and not to treat them organ by organ “like they do at some of the private hospitals”.
Yet the good doctor chose to go to this pit of a private hospital instead of opting for the public system.. Why ? As he claims quite validly, he does know better…
Yet he CHOSE to go there
The Docs to day seems to have taken the oath of Shylock and not the oath of Hipocrates. The mistake is that people tend to rush in every small ailment to the doctors and these fools never try any home remedies and doctors make use of the situation. So it is very pathetic.
A La Sri Lankan Style.
They always complain of high prices. Yet, they do not know that we live 21st Century and money value went down more than 50%. When I came to UK from Sweden in 1997 the bus fare was £0.70 and now it is £2.30. and it is just for one bus stop travelling or to a any destination in London itself unless you carry a prepaid Oyster for a cheaper fare. This £2.30 is equivalent to Rs. 500 in Sri Lankan money.
I work for National Health Service in UK and used to work in a private hospital in St John’s Wood, London. If that doctor went for screening in that hospital he would have definitely had to pay about £2000 which would amount to Rs400 000 and if he wanted that done at NHS he would have to go to GP and the GP should send a requisition to a hospital and he would have to wait at least 3 months before he receives an appointment with a specialist. That specialist should request all these screenings only if he/she believes this person needs to be screened. I know all this because that I have been under constant watch for having a heart attack at very young age.
We Sri Lankans must be very thankful for what we get free and the good things we have in our motherland. On one hand Tamils are complaining and on the other hand our own Sinhalese complain and nothing is good there. What is good for them is second class treatment they get in foreign countries that come with 5 stars (Democarcy, Human Rights, Equal Treatment, Diversity and High Costs)
The point of this story is not the price. Please understand that there are so many doctors who try to fleece patients out of as much as they can by prescribing a range of perhaps unnecesary tests.
People when they are ill praise doctors and pray to god when they get better they scold doctors and forget god
Well your attempt to kill the messenger is quite obvious. We too have seen those local hoodlums calling themselves doctors in SL (by the way I have also consulted those in the West and in India too !). Myself and my family were fleeced by the local doctors on many occasions. They are a Mafia that fleeces the sick and the poor. The doctor/patient who has complained here has all the right to get a check up done in SL whether it’s due to the relatively cheap service (or to support those ‘poor & greedy’ LOCAL DOCTORS !).
The problem is not there, the problem here is the attempt to fleece !!
Without trying to shoot down the messenger, Dr.Harold Gunatillake should address the main issue, which is ordering unnecessary tests. Most times the doctors insist on a particular place where they want the tests carried out. The eye doctor will want the scans etc. done at a particular ‘house’ where the first thing they ask is for the name of the doctor who sent us there (for obvious reasons). The diabetes doctor will order insulin from one particular agent (again for obvious reasons). This is the order of the day.
As someone has pointed out earlier, when we leave earth, we take only the good deeds we have done … not our house deeds !!
Well, I think this said patient was greed personified. I have paid far more for treatment here, and it is still way cheaper than in UK, where I always had private treatment. I have been an in-patient in Colombo and Galle, where I live, and am 95% happy with all treatment, more than I can say for my occasional NHS visits, for which months of waiting were reuired.
Regards from “very happy in Sri Lanka”
When someone voiced out the way he has been treated at a certain hospital/Doctor why is it that so many have found out from where he has come from and what he is trying to do etc..I too have fell in to these traps of these consultant docotors trying to earn money for the hospitals that they are been channeled at.they earn a commission from those tests too.
total channelling charge for a doctor is 1600 (this is just for 5-10mnts without medicine ).isnt this unfare too.