Rationalising doctors' fees, diagnostic charges

In Bangladesh, when patients seek medical assistance to alleviate diseases or reduce health-related troubles, they often encounter exorbitant fees and unnecessary charges for pathological tests. A high-ranking government bureaucrat receives a basic salary of Tk.78,000 per month, equivalent to Tk. 2,600 per day on average. In contrast, a specialized doctor, in addition to their regular government job, earns Tk.10,000 to Tk.16,000 every evening by seeing 20 patients, charging Tk.500 to Tk.800 per visit lasting 10 to 15 minutes. Some doctors attend to more than 20 patients each evening. Even for a specialist, the charge per patient visit should not exceed Tk.200. Therefore, a doctor can earn Tk.100,000 in 25 working days per month, alongside their regular salary and benefits, even if they charge Tk.200 per patient visit.
It is a common complaint that during the initial appointment, doctors often prescribe a lengthy list of diagnostic tests, many of which turn out to be unnecessary. Doctors should utilise their education and experience to determine which tests are essential. The question arises: why do doctors advise patients to undergo more tests than necessary? The answer is apparent. Diagnostic clinics charge patients double the amount, with details of the prescribing doctor recorded. Allegedly, half of the charges collected from patients are provided to the doctors involved. However, there are many doctors who refuse such payments and act ethically.
The Ministry of Health must intervene to rectify the situation. Decades ago, the government set fixed fees for doctors and diagnostic test charges, which should be strictly enforced. The current diagnostic charges of Bangabandhu Sheikh Mujib Medical University (BSMMU) could serve as the standard. The evening private practice fees established by BSMMU for doctors could also be applied to other doctors engaged in private practice. These fixed fees and charges should be widely publicised through print and electronic media. Doctors and diagnostic clinics that violate government-fixed fees and test charges should be penalised according to the law to uphold government directives. This would enable most patients to access healthcare services at affordable prices.
We would like to believe that doctors are not akin to greedy traders whose sole aim is to exploit customers for abnormal profits. The relevant government authorities should take necessary steps to establish charges for pathological tests, consultation fees for doctors, and enact laws to impose financial penalties for violating government-set rates.
Md Ashraf Hossain
8/A, Rmna, Dhaka-1000
[email protected]