Doctors Authorizing Unnecessary Tests to Earn Commissions

Several doctors have admitted to authorizing needless tests just to earn commissions during a meeting chaired by officials of the Kenya Medical Practitioners and Dentists Union (KMPDU).

One radiologist revealed that most of the private practitioners are forced to prescribe tests that were needless from a medical standpoint.

The medic went on to reveal that some testing facilities have a policy of offering commissions whenever patients were referred to their establishments as a huge motivator.

“That is why you get a two-year-old with Computerized Tomography (CT) scans they do not really need, we get people doing many tests on patients that are unnecessary,” the practitioner revealed.

In their defence, the private practitioners vented their frustrations towards insurance firms.

They accused these firms of delaying payments meant for private clinics.

One doctor went on to explain how they are forced to wait for months and sometimes years for reimbursements in silence, as any complaints laid against the insurance firms are construed as hostile leading to a drop in patient referrals.

Insurance firms are known to recommend which hospitals and doctors their clients should visit.

This has given them the upper hand as they can deny them business at will thus forcing doctors to come up with crafty ways to stay in business, such as bribery.

“It is only in the medical field that you find decisions are made by third parties through panels. To get into that panel to push for your rights, you have to bribe someone,” a dentist was quoted by The Standard.

KMPDU Secretary-General, Ouma Oluga, resolved that the doctors would create a consultancy firm mandated to push insurance companies to honor payments.

KMPDU Secretary-General, Ouma Oluga, disclosed how these insurance companies delay payments for over a year on purpose so as to rake in their premiums at the end of the year.

He went on to reveal that the doctors are yet to receive over Ksh700 million in claims against insurance firms.

They, therefore, resolved to create a consultancy firm mandated to push insurance firms to honor payments within a maximum of 30 days as a long term solution.

In addition, the doctors in their resolution agreed to work towards dissolving insurance company panels which they claimed was comprised of individuals with no experience in the medical field.


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