National Accreditation Board for Testing and Calibration Laboratories (NABL) certification is a key indicator that the lab is meeting national standards
GUWAHATI: In Guwahati, patients are beginning to ask a critical question: How reliable are the diagnostic centres they are being referred to by their doctors? Diagnostic tests are essential for accurate diagnosis and treatment, but recent reports have shed light on a widespread practice in India – doctors receiving commissions from labs for referring patients to specific diagnostic centres.
Across the country, it is common for pathology labs to pay commissions to doctors, with rates typically ranging from 40% to 60% of the total fees. This practice isn’t new, but it’s now under greater scrutiny in Guwahati as patients start questioning whether their health is truly the priority.
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For many patients in Guwahati, the experience of visiting diagnostic centres has become a frustrating and disheartening ordeal.
Talking to GPlus, a resident of Chandmari seeking anonymity said, "I had gone to see a doctor on GS Road, and after examining me, he recommended a specific lab for my tests," she said. "But that lab was charging more than I was comfortable paying, so I decided to go to a diagnostic centre near my home, which was more affordable."
However, things didn’t go smoothly when she returned to the doctor. "When I showed him the test results from the other lab, he became rude and started misbehaving with me. It was really upsetting," she explained. "I didn’t expect that from a doctor. I just wanted to save some money by going to a different diagnostic centre, but he seemed more concerned that I didn’t go to the lab he suggested. It made me feel like he might be getting a commission from these tests, which is something no patient should have to worry about."
This incident showcases the dilemma faced by many patients. On the one hand, they want to trust their doctor’s judgment, but on the other, they feel uneasy about the financial motivations that might be influencing their care. The doctor’s refusal to accept test results from a different lab, particularly one chosen by the patient for its affordability or convenience, raises concerns about the ethics behind such recommendations.
From the perspective of some doctors, the decision to recommend specific diagnostic centres isn’t about money but trust in the quality of the tests.
Talking to GPlus, an official from a private hospital explained, “You cannot just assume that every doctor is accepting commissions. That is not fair to them. Doctors tend to recommend only a few diagnostic centres because they’ve built up trust with those labs. They know the results will be reliable, and that's really important for accurate diagnosis.”
The official stressed that it is not about financial gain. “It is about 100% trust in the lab. If a doctor is confident that a particular centre will give the right results, they’re going to send their patients there. Their priority is the patient's well-being, not personal profit,” the official added.
However, trust is a double-edged sword. While some doctors may genuinely rely on certain diagnostic centres for their quality of service or accurate results, others may be motivated by commissions, leading to biased recommendations. As a result, patients are left to question whether the doctor’s judgment is based on their health needs or personal financial benefit.
Behind closed doors, there is often an uncomfortable truth.
A senior official from the Assam Health Department, speaking to GPlus said, “When you see doctors recommending only one or two specific diagnostic centres, it is often because they are receiving commissions,” the official said. “In many cases, these commissions can range from 40% to 45% of the total fees charged by the lab.”
The problem becomes particularly concerning when doctors recommend private diagnostic centres despite the availability of government labs that are equally capable of conducting the required tests. The official pointed out that private doctors’ reluctance to refer patients to government labs, which are often more affordable, raises valid questions about their motivations.
When it comes to ensuring the credibility of diagnostic centres, regulation plays a crucial role, and this is something patients may not always be aware of.
The official from the Assam Health Department highlighted the importance of accreditation. "If a diagnostic centre or lab wants to operate, they must be certified by the National Accreditation Board for Testing and Calibration Laboratories (NABL)," the official explained.
"This certification is a key indicator that the lab is meeting national standards and maintaining the quality necessary to provide reliable results."
The official emphasised that NABL certification is not just a formality, but a crucial step in ensuring patient safety. “It is not just about running tests. The accreditation process makes sure that diagnostic centres are equipped with the right tools, practices, and expertise to give accurate and trustworthy results. Patients should know that when a lab is NABL-certified, they can have confidence in the tests being conducted there,” the official added.
In addition to NABL certification, diagnostic centres and clinics are expected to follow the Clinical Establishment Act, which lays down guidelines for their operation. An official from the National Health Mission (NHM) pointed out the significance of this law, stating, “Any clinical establishment should follow the Clinical Establishment Act. This ensures that they are regulated and that patients are protected from malpractice.”
The official added, “We regulate government doctors and ensure there is no malpractice in government labs. But when private doctors recommend only a few centres, people have the right to ask why they are not referring patients to government labs when they are available.”
The National Medical Commission (NMC) guidelines, which are designed to protect both doctors and patients from malpractice and negligence, emphasise that medical practitioners should prioritise the interests of patients over personal or financial considerations. However, as the Medical Council of India (MCI) does not have specific guidelines regarding commissions accepted by doctors through referrals, patients are often left vulnerable to exploitation.
“I expect my doctor to look after my health first, not think about which lab is going to pay him the most for sending me there,” said another patient who preferred to remain anonymous. “It is hard to know who to trust when you are not even sure if the lab they are sending you to is the best one for the job, or just the one that pays them the most.”
While some doctors may genuinely recommend certain labs based on trust, the practice of accepting commissions casts a shadow over these recommendations. Patients, who rely on their doctors for honest advice, are left questioning whether their health is truly the priority or if financial interests are at play. This lack of transparency and accountability from both healthcare providers and diagnostic centres is troubling. How can patients feel confident in the tests they undergo? Who is watching out for their best interests? Until these pressing concerns are addressed, the credibility of Guwahati’s diagnostic centres will continue to be questioned.