Pune: What has long been murmured in private has now come out in public - India's private healthcare sector largely treats patients as mere "revenue generators", according to a study that reveals shocking testimonies of corruption.

Irrational drug prescribing, kickbacks for referrals and unnecessary investigations and surgical procedures are widespread in the private healthcare system, said Pune-based gynaecologist Arun Gadre who interviewed 78 doctors across India.

Kickbacks for referrals included an example from a general practitioner in Maharashtra, who said that doctors get Rs 30,000-40,000 for referring patients for angioplasty.

A pathologist said that of the 150 doctors contacted only three were willing to refer patients for investigations without kickbacks.

"To find out about malpractice in India's private healthcare sector, I recorded, with their consent, face to face interviews with 77 doctors, and I interviewed one doctor by e-mail. They came from the cities of Bangalore, Chennai, Delhi, Kolkata, Mumbai and Pune or from towns in Maharashtra," Gadre noted.

"These interviews indicate the alarming extent of the deterioration of rationality and ethics in India's private medical sector and the need for stringent, transparent and mandatory regulation," Gadre wrote.

Many interviewees mentioned unnecessary investigations and surgical procedures.

One example was gynaecologists performing ultrasounds without indications in pregnant women who complain of trivial abdominal pain, then fabricating false reports of cervical abnormalities and advising the women to have cervical stitches, with the pretext of preventing miscarriage.

Few patients request a second opinion, and the doctor does not give them any documents to avoid being found out.

Another example given by a pathologist was referred to as the "sink test".

The referring doctor advises a battery of laboratory tests despite no suspicion of pathology. Only a few of the tests are performed, and the extra blood collected is dumped in the sink.

Fabricated results are then given in the normal range for all tests that were not performed.

The patient pays a large sum, which is shared by the referring doctor and the pathologist, the study noted.

Indian medical associations claim that few doctors indulge in unethical and irrational practices, but several interviewees opined that few doctors are unaffected by increasing commercialisation.

These interviews underscore one fact - paying money does not guarantee good healthcare, Gadre pointed out.

The study appeared in The BMJ (formerly The British Medical Journal).