Today, a court in Poland has sentenced a famous surgeon to a fine and a short suspended prison sentence for accepting bribes from patients. The doctor was running a public health care heart clinic and was also actively operating. All questionable incidents included envelopes with amounts of money ranging from app. $50 to $1000, given post factum, to express gratitude for succesfully operating the patient. At the same time the court has found that non-cash gifts (such as a bottle of expensive cognac or a box of chocolates) that the doctor received were not bribes and they were customary in such situations.
So my question to you guys is - how stuff like this is perceived in your country (considering Poland has a bit of corruption tradition, I expect this to be viewed more strictly than it is in Poland).
What would be the name of said surgeon?
Quote from: Syt on January 04, 2013, 04:49:18 AM
What would be the name of said surgeon?
If you are asking, you are probably thinking about the guy in question as he is operating abroad now. His first name is Miroslaw and his last name starts with G. (Polish press law requires that names of suspects and sentenced people are shortened unless the court orders their publication, but I could probably google it up if you need it, as he was the head of a prominent clinic some time ago).
The last name is Garlicki.
And it is pretty much the norm here.
If you ever need medical care in this country, make sure to slip some cash to the doctor, to the nurses if you are in hospital, etc. It is expected and a lot of them handles you with great disrespect if you don't pay. They do earn shitty wages though.
This seems to be strictly a Third World problem.
Quote from: Martinus on January 04, 2013, 04:52:07 AM
The last name is Garlicki.
Nah, doesn't ring a bell. When I was still working for the pharma research company we would get requests a few times a year to document all payments made for the past x years to certain doctors in Eastern Europe because there were allegations of corruption against them. Once we were asked to work with prosecution in Poland because some hospitals were suspected to bill both us and the health insurances for their services.
Fortunately, our company was pretty strict on not participating in such practices, though we did work with some of the doctors in question (one Serbian doctor later hung himself before appearing in court) - in some cases we actually withdrew a study from doctors for ethical reasons, and we had an annual training about what not to do.
Older patients sometimes give the nurses 10 Euro or a box of chocolates when spending time in the hospital. Not the doctors though.
There was a huge scandal about doctors accepting bribes to move people forward on transplantation waiting lists recently. I am sure people will go to prison for that.
Quote from: Zanza on January 04, 2013, 05:27:56 AM
Older patients sometimes give the nurses 10 Euro or a box of chocolates when spending time in the hospital.
There was a huge scandal about doctors accepting bribes to move people forward on transplantation waiting lists recently. I am sure people will go to prison for that.
Was the scandal in the Eastern or the Western part?
They found the first cases in Lower Saxony. Then they started to review all transplantation programs in Germany and found cases in Bavaria and Saxony. I am sure those won't be the last. However, all of them seem to be unrelated, so there is no transplant mafia.
The first guy they found got a bonus of 2000 Euro per liver transplant in his work contract, which is a nice sum of money when you do 40 per year. So he had a monetary incentive, but not directly from the patients.
I just read an article about it and it is apparently not clear whether they even got money for it, most likely not. In some cases it looks like they falsified the data so a patient with reasonably good health has a better chance to get an organ before deterioration without the patient even knowing, e.g. by claiming the patient needs dialysis when he actually doesn't.
The system as it is gives organs to the most ill patients and that's quite controversial among doctors as some would prefer to give them to those that have the best chance of getting healthy again.
I used to live with a ward sister who'd regularly bring home flowers and boxes of chocolates from grateful patients. She also met rich boyfriends through work and used to hang out on Simon Le Bon's yacht at the weekend. I've never heard of doctors receiving bribes, but there was a recent scandal about Muslim doctors being paid to help to arrange illegal female circumcisions :yucky:
In the past, such gifts or bribes were very common in HK. In fact they were "required" if you wish to have a successful visit to the clinic/hospital. That was 40 or 50 years ago. The government ruthlessly stopped such practices starting from the 70s. Any gift to medical staff, in cash or otherwise, are considered bribes. There are heavy prison sentences if you accept them. Of course, another effective measure was to raise civil service salary.
Nowadays it is very rare to provide gifts to medical staff. Probably the only people who do it are recent immigrants or tourists from the mainland, where such practices are still common.
i don't get how it's a bribe if it's after the fact. Unless it was a wink wink sort of way to try to get around the bribe. ie it was set up before the operation but paid out after the operation. it's also weird to distinguish between cah and non-cash. i mean, what the difference between getting 300 dollars or a 300 dollar bottle of cognac.
I think gifts with nominal value, like a card, some flowers or snacks for immediate consumption are in practice ok. A bottle of cognac is definitely not.
The same thing happens in the U.S. -- you have to give doctors a lot of cash if you want medical care.
Quote from: Grinning_Colossus on January 04, 2013, 07:49:35 AM
The same thing happens in the U.S. -- you have to give doctors a lot of cash if you want medical care.
:lol:
Yeah the bribes are getting pretty steep these days :(
In most US states there are no official rules on the matter, but our professional organizations state that you should refuse personal gifts of more than $100. I think the true purpose of gift rules is to limit the degree to which pharmaceutical companies can influence physicians rather than prevent patient appreciation.
Quote from: Fate on January 04, 2013, 09:14:50 AM
In most US states there are no official rules on the matter, but our professional organizations state that you should refuse personal gifts of more than $100. I think the true purpose of gift rules is to limit the degree to which pharmaceutical companies can influence physicians rather than prevent patient appreciation.
I can also see an incentive in preventing the appearance of scheduling favoratism.
Quote from: HVC on January 04, 2013, 06:15:07 AM
i don't get how it's a bribe if it's after the fact. Unless it was a wink wink sort of way to try to get around the bribe. ie it was set up before the operation but paid out after the operation. it's also weird to distinguish between cah and non-cash. i mean, what the difference between getting 300 dollars or a 300 dollar bottle of cognac.
In the US it's illegal to reimburse a doctor at greater than Medicare rates if you're on Medicare. I can see where you could start to run afoul of the limit with expensive gifts from elderly patients.
Ethically there's problems with expensive gifts because your other patients may see such gifts and assume you're not providing the same level of care if a gift isn't provided.
Quote from: HVC on January 04, 2013, 06:15:07 AM
i don't get how it's a bribe if it's after the fact. Unless it was a wink wink sort of way to try to get around the bribe. ie it was set up before the operation but paid out after the operation. it's also weird to distinguish between cah and non-cash. i mean, what the difference between getting 300 dollars or a 300 dollar bottle of cognac.
I agree it's wierd to distinguish the two.
I think the "before the fact" and "after the fact" issue is this: in at least some cases, patients are likely to see physicians (even specialists) more than once. If you have received a very expenisve "gift" last time you saw the patient, the concern is that next time they need your services you will treat them better than the patient who did not give a gift - like scheduling them sooner. If this becomes known, the pressure is on to give gifts.
Well, while I agree the distinction is blurry, cash is more of a naked bribe whereas an expensive gift but one that cannot be easily resold and does not have an inherent utility is more acceptable. It's like buying someone flowers - it can be viewed more as a token of appreciation, no matter the cost.
Once it ceases to have a purely monetary value (i.e. something that can either be exchanged for cash or is something the doctor buys regularly so saves him cash) it becomes more of a potlach thing - "I am burning cash to show my appreciation for you but you are not being effectively enriched, even if you technically receive a good of some value."
Imagine a situation if a famous opera singer, happy with the result of a surgery, performed for the doctor at a private soiree. This would probably have high value, technically (perhaps the singer's fee for such private performances goes into tens or hundreds of thousands) but since this is not something the doctor would have otherwise commissioned, one cannot say he actually saved/received a cash value.
For the record, I am not saying that having the singer sing for you is the same as getting a bottle of cognac, but that there is a gradual scale there and not a purely binary situation.
Quote from: Martinus on January 04, 2013, 06:39:11 PM
Once it ceases to have a purely monetary value (i.e. something that can either be exchanged for cash or is something the doctor buys regularly so saves him cash) it becomes more of a potlach thing - "I am burning cash to show my appreciation for you but you are not being effectively enriched, even if you technically receive a good of some value."
Imagine a situation if a famous opera singer, happy with the result of a surgery, performed for the doctor at a private soiree. This would probably have high value, technically (perhaps the singer's fee for such private performances goes into tens or hundreds of thousands) but since this is not something the doctor would have otherwise commissioned, one cannot say he actually saved/received a cash value.
The issue though isn't the cash value, but whether the doctor is likely to be influenced in the exercise of his or her professional judgment - for example, to scedule the opera singer's surgery next time ahead of some schlub who didn't give the surgeon a fancy gift last time around, even though the schlub's medical condition etc. would normally rank him higher on the priority list.
a friend of mine is a nurse in the UK. just the other day she was telling me about a absolute bitch Filipina nurse she has to work with. given hints the bitch has dropped my friend heavily suspects a lack of bribes and tips from the patients in the UK is a key source of her bitch powers.
Quote from: Tyr on January 04, 2013, 08:50:59 PM
a friend of mine is a nurse in the UK. just the other day she was telling me about a absolute bitch Filipina nurse she has to work with. given hints the bitch has dropped my friend heavily suspects a lack of bribes and tips from the patients in the UK is a key source of her bitch powers.
:huh:
Translation: "She's cranky about not getting bribes"
Martinus rationalizing bribery. Yep, he's definitely a Jew lawyer.
Quote from: garbon on January 04, 2013, 10:39:03 PM
Quote from: Tyr on January 04, 2013, 08:50:59 PM
a friend of mine is a nurse in the UK. just the other day she was telling me about a absolute bitch Filipina nurse she has to work with. given hints the bitch has dropped my friend heavily suspects a lack of bribes and tips from the patients in the UK is a key source of her bitch powers.
:huh:
Makes perfect sense if you read it aloud.
Most (many?) surgeons in the UK run a private practice as well as their NHS work. If the NHS queue is intolerable one can jump it by becoming a private patient. More interestingly one can move in and out of private/public practice for a particular case. This is all perfectly legal but enables people with sufficient nous to get a first class service on the cheap while the masses make do with a second rate service.
Quote from: mongers on January 04, 2013, 11:34:54 PM
Quote from: garbon on January 04, 2013, 10:39:03 PM
Quote from: Tyr on January 04, 2013, 08:50:59 PM
a friend of mine is a nurse in the UK. just the other day she was telling me about a absolute bitch Filipina nurse she has to work with. given hints the bitch has dropped my friend heavily suspects a lack of bribes and tips from the patients in the UK is a key source of her bitch powers.
:huh:
Makes perfect sense if you read it aloud.
:unsure: or just read it normally.
Quote from: Richard Hakluyt on January 05, 2013, 05:20:33 AM
Most (many?) surgeons in the UK run a private practice as well as their NHS work. If the NHS queue is intolerable one can jump it by becoming a private patient. More interestingly one can move in and out of private/public practice for a particular case. This is all perfectly legal but enables people with sufficient nous to get a first class service on the cheap while the masses make do with a second rate service.
Here, except in certain specialized circumstances, two-tier isn't allowed.
The problem in a fully socialized system, I have found, is that influence simply replaces money as the source of getting an edge on. You are buddies with the head of oncology at Big Hospital? Have a word with him and your granny gets to the head of the line.
Oddly enough, having influence and having money tend to be highly co-related. ;)
My buddies are lazy bums.
Quote from: Tyr on January 05, 2013, 06:50:03 AM
Quote from: mongers on January 04, 2013, 11:34:54 PM
Quote from: garbon on January 04, 2013, 10:39:03 PM
Quote from: Tyr on January 04, 2013, 08:50:59 PM
a friend of mine is a nurse in the UK. just the other day she was telling me about a absolute bitch Filipina nurse she has to work with. given hints the bitch has dropped my friend heavily suspects a lack of bribes and tips from the patients in the UK is a key source of her bitch powers.
:huh:
Makes perfect sense if you read it aloud.
:unsure: or just read it normally.
I think clarity is increased slightly if you put a definite article between given and hints. I didn't register it the first time I read it.
Quote from: Malthus on January 05, 2013, 11:32:52 AM
Quote from: Richard Hakluyt on January 05, 2013, 05:20:33 AM
Most (many?) surgeons in the UK run a private practice as well as their NHS work. If the NHS queue is intolerable one can jump it by becoming a private patient. More interestingly one can move in and out of private/public practice for a particular case. This is all perfectly legal but enables people with sufficient nous to get a first class service on the cheap while the masses make do with a second rate service.
Here, except in certain specialized circumstances, two-tier isn't allowed.
The problem in a fully socialized system, I have found, is that influence simply replaces money as the source of getting an edge on. You are buddies with the head of oncology at Big Hospital? Have a word with him and your granny gets to the head of the line.
Oddly enough, having influence and having money tend to be highly co-related. ;)
Yes, there has been great disappointment here that "free" medical care has done nothing to narrow health differences between different social classes. I don't find it surprising (though 50 years of hindsight probably helps with that :P), in a modern wealthy economy "poverty" is about so much more than simple want.
I can't think of circumstances when you'd give money to a doctor or nurse in the UK. That would always look weird and probably get rejected by the recipient.
I tried to think of circumstances where you'd give a gift though and I could imagine it happening to midwives especially, or to retiring GPs. You might also give a gift to nurses if you'd been looked after well while staying in hospital or, possibly, something to a surgeon.
I gave a gift to the surgeon who fixed my leg. I know my wife was giving the rehab floor nurses stuff.