The Doctor’s Thoughts: A Medical Perspective

medical-563427_1280Evidence and Experience Overcomes Corruption

Narendra Modi, prime minister of India, announced a surgical strike against corruption in India today (November 8th 2016).  In one fell swoop, he declared all 500 (~8$) and 1000 Rs (~15$) cash notes illegal tender today. While this causes some hardship for people with small amounts of cash in hand, the implications for the formerly black money & cash rich in India are stunning. The mountains of undeclared untaxed cash are reduced to paper overnight.

The panic of the black money rich and the joy of the common man in India tonight reinforces Navya’s core values. Stay unbiased, stay independent, stay clear of cutbacks, commissions and conflicts of interest. Steer away from the murky transactions in the business of medicine.

The practice of medicine worldwide and in India both, has been mired in conflicts of interest. Pharma companies develop drugs that make you bleed uncontrollably – and aggressively market them to cancer patients until it replaces older and safer drugs. The same companies then sell antidotes to the same drug for those cursed with a major bleeding episode, profiting on both ends of the spectrum!

In India, I have had the personal shock of calling an MRI center to get a study priced – only to be rudely told that the price of the study depends on the doctor who ordered it. The charged price adds in the cutback to the ordering physician. Conflict of interest in America is more subtle but even more prevalent in dollar figures. Incentives to undertreat or overtreat patients are cooked legally into the medical system we practice in. Professional society guidelines, endorsed widely, reflect the financial incentives of medical groups rather than evidence based facts like true gains in efficacy of a treatment.

Navya, since its inception, has been evidence and experience based. We build measures of conflict of interest in our models. We do not engage in partnerships with diagnostic centers to reach their patients in exchange for referral fees.  Similarly, we do not recommend hospitals or clinical services to our patients.  We spread our word organically, from person to person, patient to patient, and physician to physician, in partnership with government mandated organizations like National Cancer Grid, and we work with true experts at Tata Memorial Centre who volunteer selfless opinions to patients. The choice of a medical treatment should be based on clinical efficacy, cost effectiveness, affordability, logistics of travel to a treatment center and patients’ tolerance of side effects – nothing else.

Our commitment to offer an unbiased, evidence and experience based expert opinion is a bedrock principle at Navya that Gitika, the experts at Tata Memorial Center and I share. To this end, the eradication of large cash transactions in India, properly implemented, could be a boost to all of us marching towards a corruption free world.

-Dr. Naresh Ramarajan

Online Expert Opinion:

Tata Memorial Center:

Tata Trusts:


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