Medical Tourism Gone Bad



Dear Sir/Madam,



This letter is primarily to inform readers of the cheating taking place at Apollo Hospitals. I have witnessed a bad experience with this hospital. (Apollo Hospital, Ahmedabad. http://www.apollohospitals.com/)

My friend contacted the several doctors in Ahmedabad to have a few moles surgically removed. They quoted him a price of Rs. 4000 before operating. However, after the procedure was completed, they charged him Rs. 8000 and would not reduce a single Rupee. When he contacted the doctors/surgeons who completed the procedure, they were not willing to speak to him. The hospital administration was equally uncooperative. They exaggerated their charges and did not bother to inform the patient. The medical tourism industry in India is so promising as it is that there is no need to scam people, but everywhere I look I find only very bad policies! As medical tourism grows in India, is this the impressions we, Indians, want to put forth to foreign visitors?

After hearing about these horrendous medical scams, I looked into large, reputable hospitals for good service at fix price. Apollo Hospital, Gandhinagar, caught my eye. It has a very nice website and is public traded in India. Giving the hospital the benefit of the doubt, I sent one of my relatives to the hospital to have a few routine medical tests done in December 2008. Prior to making the five hour trip from her place of residence to the hospital, she called to ask for rates, procedure and how long it would all take. She listed three specific tests she wanted done (Mammogram, Brain MRI, and Endoscopy). She was quoted a price of Rs. 1200 for the mammogram, Rs. 5000 for the MRI and Rs. 3000 for the Endoscopy. She was told that the procedures would be done without much delay and she could come in the next day, if she wanted. Since she was to do an endoscopy, she was told to buy a powder from the local medical store and take it to clean out her bowels/intestines. She was to consume the powder by diluting it in 2 liters of water and drink all of it within two hours of starting. After that, she was not to consume anything else. The name of the drug the person gave was inaccurate and despite visiting multiple stores, could not be located. Numerous calls to the hospital went unattended. At about 9 PM, my nephew was able to locate the drug and buy it. My relative consumed the medicine and laid awake all night in discomfort. The next morning, she woke up around 4:30 AM along with two other family members and left for Gandhinagar.

Upon arrival at 9:30 AM, she was instructed to report to the Endoscopy Department. Although the tests were outpatient procedures, the staff suggested that she take a room at the hospital, for her comfort. The three then went back to registration and she got admitted around 11 AM. She wanted to get a private, single room so that she could rest peacefully. They didn't have a single room available at that time, so instead put her in a Deluxe room for the time being. Soon nurses and technicians started visiting her and completed an initial examination. The doctor, a sly man by the name of Dr. Vohra, came in and began to talk about his prior practice in U.K. He seemed less interested with the patient as with bragging about his credentials. He handed the family members his business card and only then began to examine the patient. He asked if there were any problems, anywhere. The patient replied that she had occasional acidity (acid reflux), but it was not bothering her at the time. The doctor said, "Ok, we will take a look" and left the room after completing his examination. The patient was then left waiting in her room for many hours. Finally, at 2 PM, a nurse came to take her downstairs. However, the patient had to wait another 15 minutes for a wheelchair to arrive. Shortly thereafter, the other family members were told that they had to switch to the single room that had opened up two floors below. They got to the single room and waited for hours without being able to leave the room because there were no locks/way to secure belongings in the room. On top of that, no nurse was willing to locate the patient or what tests were done at that point.

Around 3 PM, the family members were called down to the Endoscopy Department. There, the doctor explained that the intestines were not cleared out completely so the test was only 50% successful. He kept insisting that a new test be performed the next day (at an additional cost!). The hospital took no responsibility for giving improper directions when the patient was taking the medication the first time. They wanted to put her back on the treatment and then do the endoscopy again. We refused! The family members were told that the patient would be coming back up to the room, so they went back to the room and waited for more than 2 hours without any message and without the patient returning. They went downstairs to inquire and were told that the patient had completed all of her tests and would be coming up soon. After another hour, she was still not in her room. Turns out, the hospital staff decided to leave her in the middle of the hallway, on a wheelchair, for that time. There was nobody attending to her and she could have easily fallen, as she was still sedated from her procedure. This type of gross negligence seems only characteristic of Apollo Hospital! When she finally returned to her room, she was thoroughly exhausted and uncomfortable. That night, the room was so frigid! There were no pillows for the family members nor any blankets, even for the patient!

In the morning, a nurse came to the room and demanded she be allowed to change the patient's clothing. Why would the patient need a new gown at 6AM even though she was to be discharged that morning? A dietitian stuck her head into the room for less than three minutes and asked how the patient's diet was. After a few hours, the nurses were still not processing the discharge papers, so all three family members gathered everything and went to the nurse station around 10 AM. They would not discharge her saying that the doctor was not present--SHE WASN'T BEING TREATED FOR ANYTHING!!! WHY does a doctor need to be present to discharge a person who was there for medical tests?! After several minutes of argument and convincing that the patient did not want any further tests/treatments, the nurse called the doctor. The doctor said she could leave, but it would take an hour to process everything. Two hours later, nothing was done. The medical reports from the previous day's tests had still not arrived! When the patient threatened to leave, the nurses said that a family member should go and contact the billing department. The cramped room for the billing department was overflowing with angry patients. Each of the three staff members kept saying that they could not do anything and that the person should talk to the other persons in the room! Finally the bill was printed and sent upstairs.

The bill was Rs. 19, 000!!! The hospital had charged not only for the patient's room, but had increased the charge for each test, incrementally according to the room. They had added consultation fees for the doctor, the dietitian, and a neurologist who had come into the room for less than two minutes. These consultation fees alone were over Rs. 1, 000! They added nursing fee and a fee for a medical report CD and other misc. charges.

When the patient demanded to talk to the billing department and started walking downstairs, the staff sent a member to "guard" the patients to make sure that they did not run away. (Mind you, we had already paid a Rs. 10, 000 deposit upon registration.) Once downstairs, no hospital administrator was available to explain the charges. All of them were busy cutting a New Years cake with the CEO. I can understand that it was a holiday party, but this was ridiculous. It is a hospital! Never have I heard of or seen a hospital, as whole, close or take a break for any reason. My family had to sit for over an hour to get someone to give a straight answer as to who to talk to. Finally a "duty manager" came when they threatened to leave if nobody was going to talk to them. The manager did nothing to help the patient. He said that the tests were charged according to the room the patient stayed in. Maybe it would be wise to INFORM the patient that they would be charged according to the room they select upon REGISTRATION, NOT discharge.

What was truly shocking was a charge for an Upper GI endoscopy! My family members did not know that the test was being performed, did not give consent, and only found out when the bill came! When the family members went to talk to the doctor, since no hospital administrator was willing to discuss anything, he simply raised his hands. He pointed to something he had diagnosed from the test and gave a roundabout answer about how he knew how to talk to his patients. He again began talking about working in the UK. We don't care where he worked! The tests were done in India, so how about discussing them?! The hospital did not reduce the bill even though it was the doctor's fault for doing a test without telling the family the price, the test being performed and the reason for performing it--let us not even mention that they didn't even bother informing the patient. Is this so different than the horror stories we hear about kidneys being removed from patients without their knowledge?

My family members spent the whole day trying to resolve the issue at hand. Nobody was willing to listen/talk. THERE IS NO CUSTOMER SERVICE at Apollo. At the end of the day, my family had to pay the full amount because no one was willing to listen or talk with them; it was hopeless. Exhausted, as everyone had been running around from office to office nobody had eaten, they left after 5 PM;on their long journey home.

Apollo Hospital is a fraud and a big scam. They do not exist to treat patients, but to steal from them. Nobody should return to such a fraudulent establishment!

Not all hospitals in India are bad. My family has had a good experience at a religiously affiliated, non-profit hospital in Surat. Their policy is that the patient pays money upfront and then gets the procedure so that there are no surprise charges afterward. In fact, they are very transparent in their services, fees, and overall customer service.

My purpose in writing this letter is to inform your readers about this scam and garbage service from Apollo and the likes of it. Be very cautious and demand upfront written estimates, contracts, and information. Personally, medical service in India may be cheaper, but they are still missing the service component of it all. My advice: AVOID AT ALL COST!!






Sincerely,



Bhupendra C. Patel

Pharmacist (RPh)

Chicago, USA

Hi Maria,
Thanks for your reply. I really appreciate your followup here is my complete experience for your reference. I have highlighted some areas of improvements.

1. I woke up on wednesday morning and had a lot of itching in my head. this happens sometimes but this time it was more so i asked my wife to look at it. She found that there were many little pimples like thing in my head. They also had pus in it so i was very scared. I also have been having a little headache continously for last 2-3 days and i never get headaches so i was already worried.

2. I connected to work and found out references to dermatologists in the online community board. Someone suggested apollo and Dr I. S. Reddy. Trusting the name apollo i went there. I tried to get an appointment but i couldnt get it on phone because i was told no appointments for dr Reddy. Now appointments for Dr Reddy are available online on your site also which I just saw. I would be happier if i got an appointment because i know your time is precious and so is mine.

3. I went to apollo and visited the doctor I dint know much about this so i trusted the doctor and told him what i wrote before. I also had fungal infection in my feet for which i was using an antifungal cream and showed him my head.

4. Now this point is really frustrating. The doctor did not write any diagnosis on what happened and what the treatment is for. I was really scared and thats why i went to apollo. I also specifically asked he dint tell me anything particular. He should have written the diagnosis on paper and explained to me what has happened at least on asking. He did not tell me that the disease is contagious which I found later on and can spread through combs towels etc. I can now educate you now what happened to me. He prescribed to me a multivitamin and head shampoo which is just an anti dandruff shampoo with zinc like head and shoulders and a skin cream for my feet which was not even antifungal. He asked me to come back after a month :) I want to know what was my diagnosis based on which the treatment was written I have the prescription written with me i can scan and it and send it to you for your reference in case you want that.
I complained all this to my wife but she consoled me and said doctor knows more than me so far good so i went back and did what he said religiously.
I took the multivitamins and used the shampoo and woke up next day to find that the pimples on my head have increased and i also had one on my face with pus overnight. I got scared and then i found more information later.

this is what my doctor should have told me in apollo
I had fungal infection called tinea capitis in medical terms which is a fungal infection and will need a medical treatment and not just vitamins.
itis caused by a fungus. Fungi that cause ringworm live and multiply on the upper layer of the skin and on the hair. Ringworm is not caused by a worm or other parasite.

Ringworm of the scalp is most commonly caused by the fungus Trichophyton tonsurans, which spreads from one person to another. In past decades, the fungus Microsporum canis was the most common cause, but it is a less frequent cause now.



Exams and Tests
Your doctor will probably also look at a hair or skin sample (KOH preparation) under a microscope to determine whether a fungus is present.

Tests used for ringworm of the scalp or beard include:

A KOH (potassium hydroxide) preparation, which your doctor can use to determine whether the skin condition is caused by a fungus.
A fungal culture (skin culture), which your doctor usually will do only if diagnosis is difficult or the skin condition is not responding to treatment. The test results may take 4 to 6 weeks.
please note none of the tests were done or were told to me.
Medications
Antifungal medicine (pills or liquid) and shampoo used together are most effective in curing ringworm of the scalp and beard.

Depending on the medication, antifungal pills are usually taken for 4 to 12 weeks.

Medication Choices
The most common antifungals you can use to treat ringworm of the scalp or beard include:

Griseofulvin.
Allylamines (including terbinafine and naftifine hydrochloride).
Azoles (including miconazole, itraconazole, ketoconazole, fluconazole, clotrimazole).
Antifungal shampoos are used to treat this I wasnt told about that either.



I took an antifungal pill called Griseofulvin and i am still taking it i could see the effect in one night. next night the pus and itching reduced. I have been taking this pill for last 5 days continously and i still have the itching so its not completely gone but i can say with a lot of confidence that nothing would have happened with multivitamins


Thanks
Mukul