Healthcare in India needs sunshine, not secrecy

Recently, 27 doctors were identified by the National Medical Commission for allegedly accepting nearly Rs 2 crore worth of freebies from pharmaceutical giant AbbVie. According to reports, these doctors were allegedly rewarded with extravagant foreign trips, luxury hospitality, and conference-related benefits, including visits to Paris and the French Riviera, in exchange for prescribing the company’s products.

Many Indians reacted with shock and anger. Unfortunately, this is not the first time doctors have been accused of accepting cash or benefits in exchange for prescribing medicines. Every few years, another scandal surfaces, with a different set of names, followed by an investigation.

Financial incentives can sometimes influence medical decisions. Yet each revelation feels like an act of dishonesty and betrayal.

More from Opinion

Why does it feel like a betrayal?

It feels like a betrayal because most Indians still carry a deeply rooted civilisational belief that the Vaidya is next only to God. For generations, doctors have occupied a sacred space in our society. We trust them intrinsically with our bodies, our children, and our lives. When that trust appears compromised by financial incentives, the emotional reaction is not merely disappointment; it is a sense of being deceived.

However, the larger problem that many of us are refusing to acknowledge is a reality that has already arrived.

Healthcare is an industry

Hospitals are now increasingly owned by private equity funds. Pharmaceutical companies are publicly traded, with their primary accountability being to shareholders, not patients. Medical journals depend on industry funding. Seventy per cent of clinical trials are funded and sponsored by pharmaceutical manufacturers. It is not just doctors, but also insurance companies, hospital chains, device makers, consultants, lawyers and investors, who form part of a vast healthcare ecosystem.

Profit is not an accidental by-product of this system. It is one of its primary drivers.

This does not mean every doctor is corrupt. Far from it. Most physicians continue to serve patients with integrity and dedication. Nor does it mean that every interaction between doctors and pharmaceutical companies is unethical. Medical research, education and innovation often require collaboration.

The problem arises when financial relationships remain hidden. Conflicts of interest are like infections. Left hidden and untreated, they spread quietly through the system until public trust itself becomes the casualty.

A Proposed Solution for India

The United States sought to address this issue through the Physician Payments Sunshine Act, enacted in 2010 as part of broader healthcare reforms. Under the Sunshine Act, pharmaceutical and medical device manufacturers are legally required to report payments and transfers of value made to physicians and teaching hospitals. This information is published through the Open Payments database, allowing anyone to see financial relationships between healthcare professionals and industry.

The law was built on a simple health principle: sunlight is the best disinfectant. The thinking behind the law was remarkably straightforward. American lawmakers recognised that relationships between doctors and drug manufacturers would continue to exist. Banning every interaction was neither practical nor desirable.

However, patients had a right to know whether their physician had received consulting fees, research grants, travel sponsorships, speaking fees, expensive dinners, gifts or conference funding from pharmaceutical companies.

The objective was not to criminalise collaboration. It was to ensure that patients could make informed decisions and that doctors remained accountable to public scrutiny. The goal is not to amputate every relationship between doctors and industry. It is to diagnose potential conflicts early and manage them openly.

The United States is not the only country to embrace transparency in healthcare. Australia has required disclosure of industry-sponsored events since 2007. The Netherlands maintains a public register of payments made by pharmaceutical and medical device companies to healthcare professionals and patient organisations. The details differ, but the principle is the same: patients have a right to know when money changes hands within the healthcare system.

Doctor is not God

India has adopted many aspects of the modern American healthcare model, from corporate hospitals to insurance-driven healthcare and pharmaceutical marketing practices. But we have failed to adopt one of the most important safeguards developed to manage conflicts of interest. That imbalance needs correction.

India urgently needs a similar framework. If a pharmaceutical company sponsors a doctor’s conference trip, let it be disclosed. If a doctor receives consulting fees from a drug manufacturer, let them be disclosed. If a hospital receives research funding from industry, let it be disclosed. Transparency does not imply guilt. In fact, it protects honest doctors by distinguishing legitimate professional relationships from unethical influence.

In a healthcare system increasingly shaped by commercial incentives, transparency is not an attack on doctors. It is a protection for patients, ethical physicians and the credibility of medicine itself.

The uncomfortable reality of the 21st century is that every patient must become an informed participant in healthcare decisions. Blind faith is no longer enough. Your health is ultimately your responsibility, and transparency is the first step towards helping citizens exercise that responsibility wisely. Healthcare is too important to be left to blind faith, and transparency is not merely a policy option; it is the prescription.

(Anu Lall is Founder of TKS Foundation, lawyer, author, with a career in the pharmaceutical and technology industries across Asia, the USA and Europe. Views expressed in the above piece are personal and solely those of the author. They do not necessarily reflect Firstpost’s views.)