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CHENNAI: The numbers speak of Chennai’s rise as a medical capital: More than two lakh cataract surgeries in a year, a two-fold jump in caesarean section, a sharp spiral in hysterectomies. They also belie an uncomfortable truth: Doctors are increasingly becoming scalpel-happy.If your doctor asks you to undergo a cataract surgery, hysterectomy, gall bladder or tonsils removal, or an operation of the lower-back, please take a second opinion. Wide-ranging interviews with surgeons who testified before an NGO on corrupt practices in hospitals told TOI that often patients are forced to undergo unnecessary surgeries .A senior orthopedic surgeon in a corporate hospital explained the reason behind this unsettling trend: "We have a quota to meet every month. Many of us see patients as a potential candidate on our operating table. Only two out of five, however, agree. Many go for a second opinion – and don’t return."The surgeon is among the 78 medical practitioners who provided testimony to Pune-based NGO SATHI (Support for Advocacy and Training to Health Initiatives) that compiled a report on unethical practices and corruption in healthcare. From Chennai, 12 doctors testified.SATHI coordinator Dr Abhay Shukla said elective surgeries (that do not involve a medical emergency) are the most popular. "Many of these surgeries don’t involve too many risks, while at the same time fetches more revenue for the hospitals," he said.SATHI in February compiled a report on corrupt practices in healthcare. "A doctor said he was pulled up by the hospital administration for having only a 10% ‘conversion rate’ – referring to the number of patients who were advised to undergo surgery," said Dr Shukla. "To be fair, the doctors are not entirely at fault. For a Rs2 lakh surgery, the doctor, probably gets Rs25,000, while the rest goes to the hospital," he said.Most of the doctors TOI spoke to preferred to talk on condition of anonymity. "It is easier to practice independently. It gives you more freedom to serve your patients’ interest. But, more people are drawn to the glamour attached to corporate hospitals," said a cardio-thoracic surgeon at a multi-specialty hospital. He said doctors in his hospital are paid according to the number of procedures they undertake.Dr George Thomas, former editor of the Indian Journal of Medical Ethics, said the country has few guidelines to check the practice. "Any system that rewards a doctor for the number procedures he does is liable to abuse," he said. In many other countries, treatment procedures are framed by associations of different specialties along with government organizations.Not every patient, however, is falling prey – many go for a second opinion. A patient narrated how his shoulder pain got better with exercise although a cardiac surgery was prescribed, while another spoke of how physiotherapy cured his back pain for which a surgery was recommended.Doctors, however, caution that not all elective procedures are unnecessary. "I usually recommend surgery early for the elderly as they have a lot of other conditions like diabetes and hypertension that could aggravate their problem. We undertake procedures as a precautionary measure," said geriatrician Dr V S Natarajan. Doctors say, in some cases, the patients’ themselves ask for a surgery like in the case of many cesarean sections.