# Bribing medical doctors in your country.



## Encolpius

Hello, the inspiration was a newspaper article where I read, and of course I agree, that every third patient bribed a doctor in the last five years in the Czech republic. The article says the bribe was usually a small gift, but in some cases the price of the "gift" was over 1500€ (that is the double of the average salary here). The most bribed specialities are here dentists, gynaecologists, obstetricians, psychiatrists (that surprised me) and orthopaedic surgeons. I think bribing doctors is even more common in Hungary. People usually want to achieve better and quicker treatment or surgery, or choose a concrete surgeon, obstetrician or doctor in general. I'd call that real bribing. On the other hand many people give the doctors small gifts, flowers, sweet, coffee for female doctors, or bottle of whiskey for male doctors, let's call it as a sign of gratitude. In villages people also give eggs, vegetable, fruits made at home. 
My questions is:* is it common to give something to a doctor or even bribe a doctor in your country? *
The reason here (and I think in most post-communist countries) is many doctors tend to be underpaid here. 
Thanks for your contribution.


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## Miguelillo 87

Well here in Mexico you don't bribe them. 

If you want to receive tratment in a faster way or have oyur surgery done when you want to, you go to a private hospital and pay for that.

The public service, well doctor cannot take teh desition when or not to operate there are waiting lists, and those are managed for other persons not for the doctor, so maybe you will need to bribe this perosn not the doctor.


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## Encolpius

That factor did not occur to me, I mean, private hospitals. They are still only few here in the Czech republic and it is more business than better quality. And bribing is still cheaper than a private hospital care here.


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## ewie

Miguelillo 87 said:


> If you want to receive tratment in a faster way or have oyur surgery done when you want to, you go to a private hospital and pay for that.


Exactly the same here in the UK.
I imagine a lot of patients give surgeons/doctors gifts _after_ treatment, though.


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## Frank78

If you want to bribe a doctor you better get a private health insurance 
They earn up to 3 times as much than from patients with a national health insurance.

Presents for doctor are quite uncommon over here. If you stay longer in hospital you rather give the nurses a small gift, e.g. some sweets, coffee, etc.


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## Adolfo Afogutu

Encolpius said:


> The reason here (and I think in most post-communist countries) is many doctors tend to be underpaid there.


I find your thread very interesting. In this corner of the world, doctors working for our National Health System are not only underpaid, but also overworked, at least the majority of them. Nevertheless, I have never even heard of anybody doing something like that. Our system has many problems, mainly of attitude towards patients, but not the one you have mentioned.
Regards


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## Paulfromitaly

Miguelillo 87 said:


> If you want to receive tratment in a faster way or have oyur surgery done when you want to, you go to a private hospital and pay for that.


There's a problem, however: if, as it often happens in Italy, patients only trust one doctor who happens to work in a public hospital rather than in a private one, the "go private" option is not practicable.
Bribing is common practice in Italy, especially in situations where people can try to excuse their dishonest behaviour due to circumstances that are beyond their control, like poor health.


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## Ivonne do Tango

Encolpius said:


> Hello, the inspiration was a newspaper article where I read, and of course I agree, that every third patient bribed a doctor in the last five years in the Czech republic. The article says the bribe was usually a small gift, but in some cases the price of the "gift" was over 1500€ (that is the double of the average salary here). The most bribed specialities are here dentists, gynaecologists, obstetricians, psychiatrists (that surprised me) and orthopaedic surgeons. I think bribing doctors is even more common in Hungary. People usually want to achieve better and quicker treatment or surgery, or choose a concrete surgeon, obstetrician or doctor in general. I'd call that real bribing. On the other hand many people give the doctors small gifts, flowers, sweet, coffee for female doctors, or bottle of whiskey for male doctors, let's call it as a sign of gratitude. In villages people also give eggs, vegetable, fruits made at home.
> My questions is:* is it common to give something to a doctor or even bribe a doctor in your country? *
> The reason here (and I think in most post-communist countries) is many doctors tend to be underpaid there.
> Thanks for your contribution.


 

I really don't think that happens in the Public Health here, even when some specialities are not very well payed, certain public hospitals in Argentina are known for its academic prestige (the first I remember is Hospital Fernández and really, it will be obsolet to birb someone there to obtain a better or quicker treatment, the excellence of profesionals is high and that quality goes to all and with no fee). 

If you have a prepaid medicine so you are paying so much mony for that, I supose nobady risk to bribe a doctor (do tue is already receiving an excellent salary for its job). But I want to clarify, the most prestigious Argentinan medical institutions are the Public Health (from "el Estado") and to birb a doctor isn't a common practice in this area (you know, do is between politics, etc., etc.),

If you want, you can give something to your doctor as a sign of affection, only of affection, and just in holidays like Christmas or New Year.

Sorry, I never studied English and I did an incredible effort to write this (I would like to say thanks to my friend Google, he also make mistakes but he knows more than me, that's for sure).


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## Miguelillo 87

Paulfromitaly said:


> There's a problem, however: if, as it often happens in Italy, patients only trust one doctor who happens to work in a public hospital rather than in a private one, the "go private" option is not practicable.


 
Here private hospitals have a very good "name" obviously only the big ones, 'cause those small clinics, They are not recommendable. 

Besides here in México in general a lot fo the private doctors work in the public service too, at least the surgeons. 



> If you stay longer in hospital you rather give the nurses a small gift, e.g. some sweets, coffee, etc.


 
I also agree on that, the touc wtih them it's much closer and affective than with the doctor.


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## Brioche

There's no bribing of doctors in Australia.  Patients may leave small gifts at Christmas.

It's very common to leave a box of chocolates for the nursing staff when one leaves hospital.


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## SDLX Master

No, we do not do that here. The only crooked ones on the take are the damn cops, regardless of how many campaigns they throw to clean up their image.


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## fsabroso

Miguelillo 87 said:


> Well here in Mexico you don't bribe them.
> 
> If you want to receive tratment in a faster way or have oyur surgery done when you want to, you go to a private hospital and pay for that.
> 
> The public service, well doctor cannot take teh desition when or not to operate there are waiting lists, and those are managed for other persons not for the doctor, so maybe you will need to bribe this perosn not the doctor.


The same in Perú.

if you want an elective surgery or want it to be done fast you go to private clinics, you pay cash or your private insurance will cover it.

In public hospitals you will be scheduled for surgery, it will fast or in appropriate time according to your medical problem, you can't bribe doctors.


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## sokol

This isn't done in Austria - you don't bribe doctors, if you want special treatment you pay for that (either as a private patient or through private insurance which covers extras not paid for by public insurance).

Some patients however may give tips or small gifts to nurses.


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## Jacobtm

In the USA, I've never heard of anyone bribing a doctor. A long wait to get a doctor's appointment is common, so it's rather surprising that bribes aren't equally as common. 

However, the "receptionists" who make appointments for doctors are the one's you'd need to bribe to get an earlier appointment, not the actual doctor.

As for bribes for better care, I don't think many people believe that their doctor is capable of giving good care but chooses not to. People tend to talk about "good doctors" and "bad doctors". I suppose since the doctor doesn't really have any disincentive to use whatever tools/tests he thinks necessary, people generally do get the best care that the doctor believes appropriate. In fact, one of the problems people see with our health-care system is that doctors reccomend too many tests, prodcedures etc, leading to high costs for consumers, but certainly not leading to the necessity to bribe a doctor once you see him.


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## Grop

France seems to be pretty much like Austria; you don't bribe doctors.

Nurse friends of mine are sometimes given presents, typically food or wine.


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## Tagarela

Hi,

Well, in Brazil, private health services usually are better than public ones, so, the first option would take your money to a private doctor or hospital instead bribing. But perhaps in some cases if one knows the _right_ person in a public hospital, the chief doctor, director whoever... I guess that bribe might occur, or even without bribing, for friendship, you know.

As for giving gifts, I myself gave a gift to my dentist after a long treatment of years when she I have my braces took off 


Good bye.:


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## Bilma

I wonder if any doctors are bribed here in USA to give people disability. There are tons of people perfectly healthy and they are on disability  collecting money from the system.


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## fsabroso

Bilma said:


> I wonder if any doctors are bribed here in USA to give people disability. There are tons of people perfectly healthy and they are on disability collecting money from the system.


Hello:

I read some about it; but it's not bribing but fraud, mostly related to Medicare misbilling.

Regards.


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## Jacobtm

I don't think the people on disability are in much of a position to offer bribes, though I don't think it's rare for a doctor to take pity on someone and sign off on medical forms that make their lives easier. For instance, diagnosing them with a more serious condition than they have to aid them in collecting money from insurance companies.


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## Paulfromitaly

Jacobtm said:


> I don't think the people on disability are in much of a position to offer bribes


No? 
I'm a disabled person who's entitled to receive let's say $ 5,000 a year.
I give my friend doc a call.. "Hey doc, help me get $ 10,000 and you'll get your fair share.."
Isn't that bribing?
In Italy there are hundreds of thousands of people who unlawfully receive a disability pension, thanks to some corrupt doctors who stated those people are disabled whereas in fact they are not.
How did those people "persuade" the docs to make a false statement?


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## sokol

Paulfromitaly said:


> In Italy there are hundreds of thousands of people who unlawfully receive a disability pension, thanks to some corrupt doctors who stated those people are disabled whereas in fact they are not.
> How did those people "persuade" the docs to make a false statement?


I haven't thought of this kind of bribing when I wrote my post above. (And of course it would be bribing, I agree on that.)

Still, I'm fairly sure that if this is done in Austria (never heard of it but I couldn't rule it out) then it certainly isn't a major problem.


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## Miguelillo 87

Jacobtm said:


> I don't think the people on disability are in much of a position to offer bribes, though I don't think it's rare for a doctor to take pity on someone and sign off on medical forms that make their lives easier..


 



Paulfromitaly said:


> No?


 
Well I think there is some doctor who have a good heart buy unfourtunatly I also think those are the less.

P.S. Good to see you again Jacob


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## Paulfromitaly

sokol said:


> Still, I'm fairly sure that if this is done in Austria (never heard of it but I couldn't rule it out) then it certainly isn't a major problem.


It is indeed a major problem in Italy: according to INPS (Italian National social security Institute) that is the institute which pays out disability pensions, at least the 13% of the people who receive a disability pension are actually not disabled people, but crooks. 
http://www.vostrisoldi.it/articolo/pensioni-invalidita-13-su-100-sono-false/14431/
Every year INPS pays 13 billion euros for disability pensions.


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## TimLA

It depends on the definition of "bribe".

There are physicians who have clinics specifically for "insurance" and "disability" claims.
The "bribe" is that they receive a fee (from a third party) for the evaluation and therapy.
In my opinion, it's illegal, but not really a bribe.
In my opinion, they should spend some time behind bars getting to know "Bubba".

I personally know of one case of a true "bribe".
A large sum of cash was given to a doc to make statements about a prominent member of a "company" so that member of the "company" would spend less time behind bars.
The doc lost her/his position, but continued to practice.
Unfortunately, that doc did not get to know "Bubba".

My second example, I would guess is fairly rare, but I'm sure exists on many levels here in the US.


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## Trisia

Adolfo Afogutu said:
			
		

> Encolpius said:
> 
> 
> 
> 
> The reason here (and I think in most post-communist countries) is many doctors tend to be underpaid there.
> 
> 
> 
> In this corner of the world, doctors working for our National Health System are not only underpaid, but also overworked, at least the majority of them. Nevertheless, I have never even heard of anybody doing something like that. Our system has many problems, mainly of attitude towards patients, but not the one you have mentioned.
Click to expand...


Emphasis on "most post-communist countries". 

During the commie years, it was exceedingly common to give a little something (money, chocolate, flowers, a bottle of wine, coffee, even quality salami!) to the doctors *before *your treatment. This ensured that you had their attention. The nurses weren't forgotten either. So although we were all insured (no unemployment...), it cost a lot to receive medical care.

Nowadays most doctors are still underpaid, but gift-giving is not as frequent. I've seen doctors refuse such "incentives", both old and young people. Some patients are "old-fashioned" and come with money/gifts and some doctors receive them, but most of the time you can choose to leave (or not) a small token of gratitude when you're released from hospital, or around Christmas, Women's Day, etc.

Still: before or after surgery, you do pay up. Not the whole cost of the operation, of course (few people can afford that). It's a sum of money for the surgeon, another sum for the anesthetist. Something to ensure their goodwill. And such payments are the rule, not the exception.



As to unlawful pensions -- during the economical crisis in the 90s many doctors tried to be kind and help out people who would otherwise lose their jobs: they declared them ill and they were able to retire for health reasons. Of course, in terms of economy, it was a bad move in the long run. 
But at the time they tried to keep individuals from losing all sources of income and I believe it rarely had anything to do with corruption.


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## Mary Therés

The only bribing of doctors I've ever heard of here in Ireland is paying for medical certs to get time off work or in college to request extensions for assignments. There are GPs who are known for writing such certs without ever even seeing the patient.


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## Paulfromitaly

Mary Therés said:


> The only bribing of doctors I've ever heard of here in Ireland is paying for medical certs to get time off work or in college to request extensions for assignments. There are GPs who are known for writing such certs without ever even seeing the patient.


Oh well, I didn't mention this kind of bribing before, but it's indeed quite widespread in Italy as well.
For some rationally inexplicable reasons some civil servants, teachers, postal employees tend to get sick the day before they are supposed to go back to work after a holiday or a long weekend..
Needless to say they can always provide a medical certificate to prove they were in danger of death and really couldn't get back from their holidays when they were supposed to


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## sokol

Mary Therés said:


> The only bribing of doctors I've ever heard of here in Ireland is paying for medical certs to get time off work or in college to request extensions for assignments. There are GPs who are known for writing such certs without ever even seeing the patient.


No need to bribe a GP for that in Austria.

If you want to get a few days off work it is easy enough to call in sick at your GP and ask him to write a certificate for a couple of days.

GPs will usually do so even if you're barely sick enough to call in sick. And if you're _*not,*_ doctors won't give you a certificate anyway, or say, _*not*_ for a bribe - they only might do so if you're very close friends with him or her: reason being, a doctor would risk his reputation (which he might do for friendship, but certainly not for a few euros).


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## Paulfromitaly

sokol said:


> a doctor would risk his reputation


This is a good point: a serious and honest doctor wouldn't want to risk his reputation.
What about dishonest doctors? 
The problem is that some people don't want their GP to be a honest, incorruptible doctor. They want a muppet who's always willing to provide false medical certificates, useless prescriptions to buy drugs they don't actually need, but they want anyway and be always at their disposal.
For these people, a GP who cares about his reputation and therefore is unwilling to fulfil each and every request they make is unfit.


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## Smithy73

In the UK it is probably more common to bribe nurses. The NHS (free healthcare system here) has two main problems: long waiting lists and appauling aftercare. In terms of surgical practices and technology it is fantastic. Bribing a doctor here won't get you higher up on a waiting list so this would be useless. If you gave a nurse some chocolates though, or some flowers, (definately not money) you may get a better standard of aftercare (i.e. sheets changed more often e.t.c.).


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## sokol

Paulfromitaly said:


> This is a good point: a serious and honest doctor wouldn't want to risk his reputation.
> What about dishonest doctors?


Well, actually there may be some around here in Austria who even might try to _attract_ patients who are trying to get illness certificates. I'm no judge about this (don't know any myself, we'd probably need statistics of our National Health Board as to whether fraud on this level - or with pensions too, as mentioned earlier - are a problem here).

I can only say that in my experience this should be rare - else I think I've had at least heard about it; or it would be a topic whenever our politicians are discussing the huge deficit caused by our health system, which they've done almost on a regular basis, regularly.

So the only think I can say is that by default, as this isn't an issue in public discussion here in Austria, it shouldn't be a big problem in Austria - although it may exist.

Actually, time spent on sick leave in Austria (which should be some kind of indicator, as far as bribing of GPs for getting such is concerned) has been on the decline for years and there only was a slight rise in 2009 (noted by the media, if I remember correctly): so it is actually more likely that Austrians tend to go to work even though ill instead of calling in sick in times of crisis: the reason being, obviously, that there's pressure from employers not to call in sick in times of crisis.

But this of course does not mean that some bribing takes place, I wouldn't like to give the impression that Austria were paradise on earth - it definitely isn't.


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## Jacobtm

Paulfromitaly said:


> No?
> I'm a disabled person who's entitled to receive let's say $ 5,000 a year.
> I give my friend doc a call.. "Hey doc, help me get $ 10,000 and you'll get your fair share.."
> Isn't that bribing?
> In Italy there are hundreds of thousands of people who unlawfully receive a disability pension, thanks to some corrupt doctors who stated those people are disabled whereas in fact they are not.
> How did those people "persuade" the docs to make a false statement?



Paul, I meant to speak about people in the USA receiving disability benefits, and I think here that the differences between European and American social programs comes to the fore here, where the benefits are slimmer and harder to access in the USA than in Europe.

I don't know exact numbers, but disability benefits typically seem to be more than one's salary only if one is working for minimum wage (about $7 an hour, but different by state). If one actually finds work, their disability benefits are lost. So living on disability puts you at about $300 or $350 a week, which barely allows one to eat and pay the bills. I also don't believe that our disabilty benefits pay more for a more severe disability. I've known people who're wheelchair bound because of cerebral palsy, and the money they received was the same, barely above the salary they'd make on minimum wage.

However, there are definitely people on disability who aren't rightly disabled, though I would assume that doctors take pity on their lack of ability/will to find a job, rather than expecting to get a bribe out of someone living on the money of a cashier.


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## Miguelillo 87

Jacobtm said:


> However, there are definitely people on disability who aren't rightly disabled, though I would assume that doctors *take pity on their lack of ability/will to find a job*, rather than expecting to get a bribe out of someone living on the money of a cashier.


 
Well about this point, I think it's kind of stupid if a doctor it's so "consider" I mean there are thousands of people who cannot find a job (more in this crisis) and I don't think that's fair. Maybe if a person had a terrible accident and you know you can help this person by "exagereting" a little bit the diagnostic. That's will be oK. But what you point about have pity just beacuse you are so lazy to find a job, that's to have corazón de pollo


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## Paulfromitaly

Jacobtm said:


> However, there are definitely people on disability who aren't rightly disabled, though I would assume that *doctors take pity on their lack of ability/will to find a job*, rather than expecting to get a bribe out of someone living on the money of a cashier.


This is not the case in Italy, however: here corrupt doctors do it to make some extra money, not out of pity.
They might do it also when the allegedly disabled people don't actually pay them any money, as long as these people are friends, relatives, colleagues or acquaintances of a politician, a police officer, a mafia guy etc, that is someone whose help might come in handy in the future..


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## Miguelillo 87

Paulfromitaly said:


> They might do it also when the allegedly disabled people don't actually pay them any money, as long as these people are friends, relatives, colleagues or acquaintances of a politician, a police officer, a mafia guy etc, that is someone whose help might come in handy in the future..


 
Yeah just in this case but.... if you are giving someone a disability it's because he is not going to work again, so ¿? About mafia guys or police officer maybe their influence can help you, but those are very special situations, besides I suppose this guys has their own doctors


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## Garbuz

To give or not to give? You look at a doctor, the way s/he's talking, the way s/he's  looking at you, and you guess what kind of person s/he is, and you figure out whether to give or not, what to give and how much to give. You should also know how to give to make it look like an act of gratitude, respect, etc. otherwise it may look offensive and have the opposite effect. Strange as it may seem, it all helps you to establish a sort of personal relationship with him/her. And it's not only about doctors, it's a rule when you come to any government controlled office. Would I prefer not to do it? Of course, I would. But let's be realistic. What with all those crazy laws and regulations, all of us need a little help from time to time. But you can always choose to be a never-to-give-a-bribe person, if you want your life to turn into a nightmare.


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## Paulfromitaly

Miguelillo 87 said:


> Yeah just in this case but.... if you are giving someone a disability it's because he is not going to work again, so ¿? About mafia guys or police officer maybe their influence can help you, but those are very special situations, besides I suppose this guys has their own doctors


Sorry if I didn't make myself clear 
A typical example: I'm a mafia guy and I want my 12 cousins to get a disability pension, that is some extra money.
I pick up the phone and call the right (corrupt) doctor - "Hello there, this is Mr mafia guy. I would really appreciate it if you could see to it that my 12 cousins get a disability pension. You don't want to see your brand new car blow up, do you? I'm sure you don't..I'm also sure that once my 12 cousins get their pension, I can find a way to return this favour..".
The doc can't really refuse to help me, but at the same time he receives something in return. Everyone is now happy 
Someone might say: well, that's not bribing, that's threatening the doctor!
This is partially true in this specific example, but the point is that the mafia guys as well as politicians or whoever wants to unlawfully be granted a disability pension turn to these morally and ethically deplorable doctors who are willing to cooperate for money.


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## tepatria

Here in Ontario, Canada bribing doctors is not done as far as I know. Our public health system does not allow for most private treatment, so we are stuck with long waits for just about any treatment. In Ontario the doctors have a list posted for charges not covered by the health care system - sick leave notes, get out of jury duty notes, examinations for job requirements, etc. Many people show their appreciation in small gifts after treatment or by donations to a medical institution. Donations are very popular gifts.


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## Encolpius

Although we have been taught bribing is bad, I am starting to feel it is a very comfortable way to get both parts satisfied. And I think it is still a lot cheaper than business based private sectors. State does not like it, because it can get no taxes out of it.


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## Miguelillo 87

Paulfromitaly said:


> Sorry if I didn't make myself clear
> A typical example: I'm a mafia guy and I want my 12 cousins to get a .


You had clarified it very, very well!!!!! and I have to say i totally agree with you I suppose here in Mexico, Narco guys do the same in some cases.



Encolpius said:


> Although we have been taught bribing is bad, I am starting to feel it is a very comfortable way to get both parts satisfied. And I think it is still a lot cheaper than business based private sectors. State does not like it, because it can get no taxes out of it.


 
Well It is suppose we have to life in status-quo well all get what they need when they need it. Bribing will be against those principles...but hey wake-up Miguel We live in real world.


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## Paulfromitaly

http://milano.corriere.it/notizie/c...rescritte-troppe-medicine-1602292381147.shtml
Another typical example of bribery involving doctors:
Pharmaceutical companies bribe (or if you prefer, cut a sweetheart deal with) general practitioners by getting them gifts or usually paying for their holidays in some lovely and wild isles where the docs are supposed to go in order to attend a "conference".
In exchange these not too honest doctors prescribe to their patients only those drugs that are produced and sold by a specific pharmaceutical company.
Not only that: they prescribe more drugs than needed.
Who pays for those drugs? Then Italian national health service.
Docs are happy because they go on holidays for free.
Patients are happy as their doc is so kind to prescribe whatever they want.
Pharmaceutical companies are happy because their business is booming.


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## Miguelillo 87

Paulfromitaly said:


> http://milano.corriere.it/notizie/c...rescritte-troppe-medicine-1602292381147.shtml
> Another typical example of bribery involving doctors:
> Pharmaceutical companies bribe (or if you prefer, cut a sweetheart deal with) general practitioners by getting them gifts or usually paying for their holidays in some lovely and wild isles where the docs are supposed to go in order to attend a "conference".
> In exchange these not too honest doctors prescribe to their patients only those drugs that are produced and sold by a specific pharmaceutical company.
> Not only that: they prescribe more drugs than needed.
> Who pays for those drugs? Then Italian national health service.
> Docs are happy because they go on holidays for free.
> Patients are happy as their doc is so kind to prescribe whatever they want.
> Pharmaceutical companies are happy because their business is booming.


 
Here in Mexico that is almost imposible, almost all drugs you can get them without prescription, in a legal form, it's supposed the pharmacians must ask for a prescription in order to sell drugs, but this never happens, all person go to the drug store  ask for the drug and it is given If you hace the money...no problem


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## Encolpius

Miguelillo 87 said:


> Here in Mexico that is almost imposible, almost all drugs you can get them without prescription, in a legal form, it's supposed the pharmacians must ask for a prescription in order to sell drugs, but this never happens, all person go to the drug store  ask for the drug and it is given If you hace the money...no problem



I think pharmaceutical companies tend to brieb doctors all over the world. 
What Miguelillo wrote is really very interesting and I cannot even belive that, ie. you get any drug without prescription. So you can get, let's say, opium-based drugs as well, I doubt.


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## mirx

Encolpius said:


> I think pharmaceutical companies tend to brieb doctors all over the world.
> What Miguelillo wrote is really very interesting and I cannot even belive that, ie. you get any drug without prescription. So you can get, let's say, opium-based drugs as well, I doubt.


 
In Mexico drug store attendants are not at all concerned about that and people can most defintiely get whatever medicines they want without prescription. When I was in highschool some kids used to get up or down with diazepam. This is not common but people behind the counter at pharmacies many a time don't have any studies about pharmaceuticals and consecuently have no idea of the effects of drugs. Their job is to sell. About the bribing thing, I agree with Miguel. At leats in the public sector, all medicines are already provided by the government for free, patients or doctors don't have a say on this. If any bribery exists, it is between the government and pharmaceutical comapnies. If you decide to go private this is unlikely to happen, doctors are extremely well paid and I can't imagine them engaging in bribery. I do know, however, of doctors who send patients to specific clinics where they happen to be shareholders. Is this bribery, business expansion, self-promotion? I don't know, but I would do the same.


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## Chaska Ñawi

This reminds me of a friend who went to med school in the eighties.  One of his most interesting courses in second year involved dealing with pharmaceutical companies and recognizing all their ways of bribing and influencing doctors.  Of course, it wasn't overt bribery, but much a much more subtle system of rewards and penalties.


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## Tagarela

Hello,

In Brazil we have this pharmaceutical thing two, in both ways, I mean, from companies to doctor and the matter of liberty of patients buying medications. 
Employees of pharmaceuticall companies usually visit doctors' offices and show them the new medication, give them some samples and so on. And they also pay for some leiseure weekends sometimes or make some propaganda in technicall conferences =).

Regarding buying medications, we usually can get more drugs without prescription than we should, and no bribing is needed, they simply sell it. 


Good bye.:


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## Miguelillo 87

Encolpius said:


> I think pharmaceutical companies tend to brieb doctors all over the world.
> What Miguelillo wrote is really very interesting and I cannot even belive that, ie. you get any drug without prescription. So you can get, let's say, opium-based drugs as well, I doubt.


 
Well believe it!!!! As mirx has said almost all drugs can be sold to anyone, even a child can buy a big important legal drug, because there is no a law who rule that.

You only need a prescription for public services, but (as mirk has already said too) the medicien it's provided for the government by free, the prescription it's merely a storage control. 

Even it's know many people in US border cross to Mexico in order to buy medicine ('cause the non prescription and also because it's cheaper) As a matter of fact It had been a thread about it, I'm gonna search it


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## mirx

Miguelillo 87 said:


> because there is no a law who rule that.


 
I am almost certain there is a law on the matter, whether it is enforced or not is a different story.


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## Miguelillo 87

mirx said:


> I am almost certain there is a law on the matter, whether it is enforced or not is different story.


 
That's true!!! But as many laws in Mexico, they are only in paper.


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## MOMO2

It is very unusual to bribe MDs in Italy.
It is usual to give presents to your GP (family medical doctor) for Christmas.
I have never heard of bribes to be common. In this field.
If you want to be treated faster you call a private hospital. I guess it will be cheaper than bribing and most of all it is *legal*.
Still one example comes to my mind: some years ago a scandal was discovered in a private clinic in Rome where a very well known MD took very high bribes to practice illegal abortions. Abortion is legal in Italy up to the 12th week (I might be wrong on the exact week) but some women decide to do it later. 
However I do not think it is very common or I would have heard of more scandals.


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## MOMO2

Paulfromitaly said:


> http://milano.corriere.it/notizie/c...rescritte-troppe-medicine-1602292381147.shtml
> Another typical example of bribery involving doctors:
> Pharmaceutical companies bribe (or if you prefer, cut a sweetheart deal with) general practitioners by getting them gifts or usually paying for their holidays in some lovely and wild isles where the docs are supposed to go in order to attend a "conference".
> In exchange these not too honest doctors prescribe to their patients only those drugs that are produced and sold by a specific pharmaceutical company.
> Not only that: they prescribe more drugs than needed.
> Who pays for those drugs? Then Italian national health service.
> Docs are happy because they go on holidays for free.
> Patients are happy as their doc is so kind to prescribe whatever they want.
> Pharmaceutical companies are happy because their business is booming.


 


MOMO2 said:


> It is very unusual to bribe MDs in Italy.
> It is usual to give presents to your GP (family medical doctor) for Christmas.
> I have never heard of bribes to be common. In this field.
> If you want to be treated faster you call a private hospital. I guess it will be cheaper than bribing and most of all it is *legal*.
> Still one example comes to my mind: some years ago a scandal was discovered in a private clinic in Rome where a very well known MD took very high bribes to practice illegal abortions. Abortion is legal in Italy up to the 12th week (I might be wrong on the exact week) but some women decide to do it later.
> However I do not think it is very common or I would have heard of more scandals.


 

Oh my God! PaulfromItaly is very right.
Some months ago a large number of medical doctors were arrested becuase they took bribes, special favors,  I can't tell of here, for prescribing some given drugs.
I did not think of this before because I thought of "bribing for faster treatments".
Look:
213.92.9.195/provinciaroma/Rassegne/.../12/86347754.pdf


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## Encolpius

MOMO2 said:


> ...It is usual to give presents to your GP (family medical doctor) for Christmas...



Really interesting. That is uncommon here, maybe isn't at all.


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## tvdxer

No, patients bribing doctors in the U.S. is almost unheard of.  Doctors usually have a high income anyway.  G.P.'s often (perhaps in most cases) earn over $100,000 a year, and specialists can earn over $500,000 - in a year.  Granted, work and training for some specialties is long (neurosurgery requires a college degree, four years of med school, and a seven-year residency, for example), but if doctors are hurting, it certainly is not for money.  

Drug companies are an entirely different story.


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## almufadado

In Portugal, there is a system implemented by Doctors where you go the public hospital to see a doctor or specialist and then he/she ask the patient if he/she is really interested in having the intervention.

This starts a conversation that usually leads to an expensive consultation in their private offices. Note that public appointments are paid by the tax payer, and the patient only has an (rapidly growing) admission fee.

This of course if the doctors "smells" money, if not they will send the patient for the 1 year to 3 years waiting list.

In their luxurious private office/clinic, they start a consultation and analysis streak where you pay in the range of 50 to 150 EUROS each and they do you " the favor" of giving analysis paid by the state (depending on you well-fare/social-security status).

In the old days, another scheme is the brand/generic trick, where they want to force to buy the more expensive medicines. Now that has been avoid by giving the patient the right to choose. As pharmacies have a central management database pharmaceutical corps know what products were sold and were, including on the radius of the clinic, and what doctor prescribed them. 

Surgical operations are the biggest "fest", because for a person to get scheduled on time (at least before they die from the disease), you have to have connection or even bribe the surgeons or their staff. Like the traditional cast system in India, in this scheme people with money or public servants get served first, then comes the tax payer that is likely to make some "noise", and on the "tail" comes (as our present president well said (can quote if you do not believe!) )  those who are the problem of the social-security system and if they died all problems were solved.

About pharmacies, some time ago, when there was little "free market" in this business, there were mostly the "taking advantages of" the ignorance and submissive stands of most patients, by tricking into to buying the most expensive product (that's commerce, yes!).

Nevertheless, if not for the openness and a "under the counter policy" in pharmacies most people wouldn't get by !

My personal estimation is that 70% of Doctors only care for "what ski resort to choose when attending "the next miraculous drug meeting" or the "causes for rashes in the growings's congress". 

A doctor in a clinic near by swaps in a 2 year basis his imported Mercedes to a Jaguar, and nowadays to a 80.000 euros Porche Cayenne. (65000+75000+80000= 220000 in 6 years and just for reference the minimum wage remains in 475 Euros what would take 463 months=38 years without eating for 40% of the population to earn).

Please note that Doctors are not alone, they stand with lawyers and engineers sucking the state tits adn stealing from tax payers ... with impunity !


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## TRG

The US has many problems with health care costs, but having to bribe doctors is not something I've ever heard of.


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## Bigote Blanco

Making "bribes" sounds terrible and is generally frowned upon and illegal in the U.S.. However, making a large "donation of money" to a hospital will get you in the back door for immediate attention from the best doctors. This is quite a common practice among wealthy people and kept quite quiet by both doctors and hospitals. It is no different than "bribes" and "donations" in U.S. politics. Elected officials never take "bribes", but always take "donations" and it will also get you in the back door for immediate attention.


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## Dmitry_86

It is really interesting to get acquainted with opinions of people from different parts of the world because medical issue is definitely among the most important along with safety and qualitative education. When I first read the thread title the first thought that came to my mind was what to bribe doctors for. We can bribe police staff and judges in order to mitigate a punishment. We can bribe teachers so that they put us better marks than we deserve. But doctors..... In Russia I can imagine several ways that may make us do so. For example, you are not satisfied with the therapy assigned by your doctor in a free-of-charge clinic. You think the doctor does not assign necessary examinations because these examinations will have to be paid by an insurance company rather than by you personally. In this case one may think of bribing this doctor.... But what for??? What will it bring??? Probably nothing because if a doctor is thought of as incompetent it would be better to go to another one even if it will be necessary to pay. Health is more important and on no account should be subjected to risks.

One more detail is perhaps more familiar tomany people especially men. When men have to go to the military registration office they also take special health certificates with them if they have any pathology that will allow them not to be conscripted into the army. Many of those who bring such certificates are usually fit for military service, but they can pay a doctor somewhere else and this doctor will invent something that is not compatible with the military service. In the militaryn office everyone is tested aswell, but there doctors usually trust health certificates brought by conscripts and they rarely check them for validity in order to confirm or refute their power.

Finally, some children especially girls do not like PE lessons at school and in order to avoid going to them they may ask a doctor to give them a special certificate. Boys sometimes also do so. 

Generally, bribery in this sphere of life is not so widespread as in politics and education. The main reason why doctors sometimes agree to do what I have described are low salaries and heavy workload. Most doctors are decent and responsible people but they have to earn for a living and that is why they search additional sources of income that are not always good.


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## WyomingSue

I have never heard of anyone bribing a doctor in the U.S.  When they write down the insurance codes to send in the bill their office will certainly put down the most "rewarding" collection of codes they can come up with, but considering that they might be audited by the insurer at any time I don't imagine they stretch it too far.  As fsabroso said, to go beyond that would be fraud, and they would be in big trouble.


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## almufadado

In the US, as the healthcare system is a private, therefore is fully paid by each person spending big lumps of money, or by the insurance either own or provided by the employer.

On the other hand the state mostly sub-contracts healthcare so doctors and companies also get the money.

The problem in the US seems to be when you do not have insurance ( "43000000 _people without insure"_or more !) and if they do not have money to buy medical care or drugs they will not have money to bribe.

The known cases of corruption are on the insurance side of the US health care system.


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## french4beth

When I lived in Quebec in the 90's, it was not unheard of for a patient to pay cash to get faster services for minor procedures such as an ingrown toenails, getting measured / fit for dentures, etc.  The provincial and federal sales taxes were pretty high at the time, so paying cash was an easy way to get quick services. And the doctors didn't have to declare the income, either.

I also have heard of some Americans going up to Quebec for laser eye surgery, etc., where it is still much cheaper to pay cash for excellent, high quality medical care than to have the same procedure done at home.

I don't know if any of the above qualifies as bribery, take it as you will.


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## frequency

I had shortly worked at a hospital as a receptionist. In Japan, most of people will not pay a doctor extra money or bribe, however, some may give a present when they especially want to do so.

But this may be one of special cases---
My mother was staying in the hospital due to cerebral homorrhage. One day my father happened to know that his friend and the doctor were friends each other.
So he decided to offer a bribe a few days before the operation.

Like my father, some will do. But some will not.


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## almufadado

frequency said:


> I had shortly worked at a hospital as a receptionist. In Japan, most of people will not pay a doctor extra money or bribe, however, some may give a present when they especially want to do so.
> 
> But this may be one of special cases---
> My mother was staying in the hospital due to cerebral homorrhage. One day my father happened to know that his friend and the doctor were friends each other.
> So he decided to offer a bribe a few days before the operation.
> 
> Like my father, some will do. But some will not.



"Better be safe than sorry !". ... sad but true !


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## lux_

Paulfromitaly said:


> No?
> I'm a disabled person who's entitled to receive let's say $ 5,000 a year.
> I give my friend doc a call.. "Hey doc, help me get $ 10,000 and you'll get your fair share.."
> Isn't that bribing?
> In Italy there are hundreds of thousands of people who unlawfully receive a disability pension, thanks to some corrupt doctors who stated those people are disabled whereas in fact they are not.
> How did those people "persuade" the docs to make a false statement?



Friends, relatives, friend of friends, friends of relatives.
Sadly, there are many cases where you don't even need a bribe.


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## Lugubert

Bribing a doctor? The idea wouldn't even occur to an ethnic Swede. We all know that the doctors know that an exposed bribe would have the patient prosecuted, and physicians would in addition to prosecution risk their licence to practice withdrawn.

Moreover, you always get the best and fastest possible care, regardless of what it costs society, so what difference could a bribe do?

Presents to staff are by law limited to a layer cake for the coffee break or a pair of home knitted mittens or the like.


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## Binapesi

No, patients don't do that.
There is no need already since you get treatment when your appointment time comes. That's how it is in Public Hospitals. There are also small public health centres (called Sağlık Ocağı) that every neighbourhood has, which GPs work in them.

It's not the patients but the representers of medical firms always visit doctors and it's not like they convince the docs only by telling them about how good the medicine their firm made is, you know. Some doctors even give extra medicine to patients like antibiotics or painkillers or etc. even though he/she needs none of it. 
It's not like every single doctor is like that off course but the medical firm representers always come and visit anyway.

About small gifts patients give .. yeah, they do, and it's incredibly sweet of them =) .. i'm studying Dentistry and our patients (usually women do that) usually bring us homemade cakes or fruit baskets filled from their gardens or other small things. It's the way they show their appreciations since they're not paying any money for their treatments because it's a university hospital and we're students.


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## irinet

Bribing in my country is a way to live. I don't know if better, but I am pretty sure of certain deaths even if you bribe meds or not! It's a horrible disease spreading over the systems and we cannot escape of it: bribing your boss,the teaching system, the protection system, the justice system, the health system, the political system, even religion. What is certain of not getting bribe is Death: it comes even if you bribe it or not. Funny enough in the end, isn't it!


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## Istriano

I think doctors in Europe should have better salaries, so there would be no need for bribing (and strikes) at all.
In Norway, doctors in public hospitals earn like waitresses in restaurants. And don't tell me that M.D.'s and waitresses share the same responsibility when it comes to life or death.
And, why waitresses can accept a tip, and doctors cannot?
In Germany, even photographs earn more than doctors in public hospitals: http://www.eujob24.de/news/2010/04/gehalt-und-einkommen-in-deutschland-gehaltstabelle/


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## irinet

You are perfectly right about this but it seems to me that the waitress's tip is not the same with the doctors' and I am not obliged to provide him the salary as a patient! The government should solve this problem not the people in suffering. This is extreme blackmail in my opinion.


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## mirx

Istriano said:


> I think doctors in Europe should have better salaries, so there would be no need for bribing (and strikes) at all. In Norway, doctors in public hospitals earn like waitresses in restaurants. And don't tell me that M.D.'s and waitresses share the same responsibility when it comes to life or death. And, why waitresses can accept a tip, and doctors cannot? In Germany, even photographs earn more than doctors in public hospitals: http://www.eujob24.de/news/2010/04/gehalt-und-einkommen-in-deutschland-gehaltstabelle/


   This evenness in salaries is one of the things that I love most about developed countries. It doesn't matter if you are the president of the company, the sales agent, or the cleaning lady. You all are in a similar line of earnings. In Mexico, a specialist doctor makes with one patient (20-min visit) the same money that he will pay his receptionist for a one-week's work.


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## Istriano

I don't agree. This is communist mentality according to which everyone should have the same salary from waste collectors to neurosurgeons (or pilots).
Neurosurgeon had to study for too many years, and is responsible of many lives. So are pilots.

Societies can survive without waste collectors (see in India), but they cannot survive without neurosurgeons or pilots.


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## mirx

Istriano said:


> I don't agree. This is communist mentality according to which everyone should have the same salary from waste collectors to neurosurgeons (or pilots).Neurosurgeon had to study for too many years, and is responsible of many lives. So are pilots.Societies can survive without waste collectors (see in India), but they cannot survive without neurosurgeons or pilots.


 Ironic, isn't it? It is precisely the most capitalistic countries who have adopted this more fair approach to distributing wealth.The neurosurgeon/bubble gum collector argument has been discredited many times.


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## Istriano

Don't you think there is responsibility difference between the two?
In the US, there aren't many differences between trained nurses and doctors when it comes to medical knowledge, but doctors earn a lot more because they have greater responsibility. Patients hardly ever sue nurses, but doctors can be sued for everything.

In the Netherlands and in Switzerland, doctors earn a lot more than average citizens, but in Norway and Germany they do not.
I wouldn't say that Germany or Norway are more developed than the Netherlands or Switzerland.


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## mirx

Istriano said:


> Don't you think there is responsibility difference between the two?In the US, there aren't many differences between trained nurses and doctors when it comes to medical knowledge, but doctors earn a lot more because they have greater responsibility. Patients hardly ever sue nurses, but doctors can be sued for everything.In the Netherlands and in Switzerland, doctors earn a lot more than average citizens, but in Norway and Germany they do not.I wouldn't say that Germany or Norway are more developed than the Netherlands or Switzerland.


 Maybe not and I am not saying that all wages need to be the same, that would indeed boarder plain communism, there needs to be some type of gauge, I agree, but the difference in salaries in developing countries is just insulting.


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## uchi.m

Istriano said:


> Societies can survive without waste collectors (see in India), but they cannot survive without neurosurgeons or pilots.


What order of magnitude of waste are we talking about here? I can bet that if there were no professional waste collection in big cities (even in Mumbai, India, I suppose), then there would be chaos all over the place.

Countries the size of Sweden don't have this kind of problem, perhaps? Stockholm is *smaller *than my(?) last _place of visit (and living)._


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## Istriano

No, in India people don't care about the garbage, they throw it away from their house/yard/garden, and just put it to rotten on the streets or on beaches.
They like their house/garden/yard clean, but couldn't care less about public places. 
Muito pior que no Brasil: http://ecoviagem.uol.com.br/noticia...urbana-ainda-sao-precarias-no-brasil-5262.asp


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## irinet

In Romania, patients cannot sue doctors, and even if they can, nothing happens. But the discussion is not only about doctors, it's about bribe and who gets it! If there were only doctors here! Bribing is a dangerous path because it leads to other dark events of our public life: blackmail, lack of resposibilities, lie, sometimes unsolved cases of death, guilt, mistrust, and diverse forms of corruption, like lack of ethics (e.g.false rewards provided to doctors by pharmaceutical corporations). There are so many that I am getting horrified about the world I was born into.


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## Doctorr

Regrettably, doctor´s salaries in Russia leave much to be desired (a surgeon´s monthly income is approx 500USD, a GP´s one is approx 800USD, a resident´s one is approx 80USD) that´s why patients usually "thank" their doctors with money. Of course, it´s illegal but...what can a doc do? He/she has to eat, drink, buy clothes and has a spouse, kids...


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## MrAbh

Here in India, bribing is common in every field, so you essentially have to bribe authorities to get your work done.
If you want a good service including the treatment, then you have to go to Private Hosipitals. And for a common man (means with limited economic means) it's so expensive that at the end of their treatment, all their savings are drained out in these treatments.
And there are government hospitals, where you have "Self Service" type attitude, you have to make all the arrangements your own. Besides, you have to wait for a month or so to be treated in the hospital.


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## LilianaB

People don't bribe doctors in the US. They may have problems with insurance companies to make them pay their bills, but they do not bribe doctors. They may bring them a bottle of brandy, if they know them well, perhaps as a gift but this doesn't really count as any kind of a bribe, and this would be mostly if the doctor has a private practice. Health care and health insurance is very expensive in the US. Regular doctors in hospitals don't really earn that much, compared to Wall Street brokers, and other corporate executives.


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## shawnee

What, no discussion from Greeks to this topic! From what I understand not so much as band-aid is applied without very many palms being greased in the Greek medical system. It is so well known that even non Greek commentators are conversant with the term 'fakellaki - little envelope'.


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## Paulfromitaly

Istriano said:


> In the US, there aren't many differences between trained nurses and doctors when it comes to medical knowledge



Oh really? 
And on what basis do you claim that?


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## velisarius

Having lived in Greece for 40 years now, I and my family have never greased any palms in the Greek medical system. (Except for some tips to very overworked nurses in a private maternity clinic, on a purely voluntary basis.) On the other hand, the only time one of us was very seriously ill, the surgeon we chose was a close relative and friend. If we hadn't had this kind of contact available, we might well have had recourse to a 'fakellaki'

I've had excellent emergency treatment for cuts needing stitches, and hurt limbs in medical centres in remote parts of Greece while on holiday, without paying a cent, and without even having to produce my national insurance booklet.

I know many cases though of people who slip money to the doctor "so that he will take care of me". This is because they know the doctor is overworked and under-paid and they are afraid he needs an incentive to do his work properly.

When I go to a doctor as a private patient I always have to ask for a receipt - it is very seldom issued as a matter of course. I've heard other people complain "the doctor didn't give me a receipt" I say "Did you ask for one? - No".

Maybe we have just been lucky but, though the system is terrible, in my experience most of the doctors are very good and in the hospitals under very bad conditions they are doing a wonderful job. My mother as an elderly person in Britain suffered a lot from incompetent G.P.'s and was dosed for months with a cough syrup for a persistent cough that lasted 5 months before she was diagnosed with lung cancer (that was after the marvelous British system managed to lose her x-rays)...but at least she didn't pay any 'fakelaki'.


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## Encolpius

velisarius said:


> Having lived in Greece for 40 years now, I and my family have never greased any palms in the Greek medical system. (Except for some tips to very overworked nurses in a private maternity clinic, on a purely voluntary basis.) On the other hand, the only time one of us was very seriously ill, the surgeon we chose was a close relative and friend. If we hadn't had this kind of contact available, we might well have had recourse to a 'fakellaki'...



Thank you Velisarius, very interesting and useful comment. In Hungary "fakellaki" i.e. little envelope is also a word with double meaning, I wonder if it exists in other countries as well. Do you mean money when writing about tips and it is interesting tips in *private *clinics, I would expect that in state-run clinics....


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## velisarius

"Fakellaki" means "little envelope" and contains sometimes a very considerable amount of money. From newspaper reports I know that sometimes doctors will demand an extra sum, typically for an operation, on top of what is provided by the patient's insurance. The monetary 'tips' I referred to are very often given to nursing staff etc. by relatives of patients who are anxious that the sick person should be well looked after. This is an example of the "jumping the queue" aspect of bribery. Even if money is not demanded outright, the client tries to ensure preferential treatment. 

In the case of the maternity clinic that I mentioned, it is accepted practise that the happy new father will be exceptionally generous and tip all nursing staff in sight. Until recent economic difficulties changed things slightly, the only women likely to give birth in state hospitals (at least in the big towns) were economic migrants. Most women of even quite modest means preferred to choose their own obstetrician and clinic, costs being at least in part covered by insurance. When a woman gives birth in Greece, the family and friends tend to descend _en masse_ to see the newborn, so freer visiting hours and a more _luxe _environment are given priority.


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## shawnee

I do beleive that Velisarius puts a rather benign veneer over the Greek fakellaki system. On my regular visits to Greece over the last twenty years I have been recipient of medical attention free of charge in the provinces. However, I am also repeatedly informed of horror stories regarding the extraction of extra (unofficial) payments for medical procedures in hospitals.


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## velisarius

It's well-known that there's widespread corruption in Greece. If the palms of the medics are greased I think it's to a large degree because that's what the Greeks have been conditioned to expect. Doctors are only human, and if a 'fakellaki' is offered most, I think, will take it-especially if they judge the giver can afford it. It hasn't been my experience though that an amount is demanded outright. It's usually a question of "How much should I give the surgeon so that he takes care of me?" The horror stories that reach the media are the extreme cases that shock even the Greeks. 

Widespread tax avoidance means that a large proportion of the population has been contributing next to nothing in direct taxes. I think this is why they are relatively happy to pay a bit extra 'on the side' to get good treatment from their doctor. It's part of the way the system works. With recent heavy increases in taxation and cuts in salaries and pensions I doubt whether people can continue to pay 'fakellakia'. Also doctors' assets are coming under scrutiny and it is to be hoped that they will not be able to go on extracting these untaxed 'perks' with impunity.


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## shawnee

http://neoskosmos.com/news/en/greeks-fight-back-corruption
Recommended reading on the _fakellaki_ issue.


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## Interfector

I've never needed to bribe a doctor, since I don't have any medical problems, and I don't think it's very widespread, although of course it happens. I just don't want to have anything in common with it.


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