I got to know that every referred case for angiography and angioplasty got a kickback of Rs 5,000 and Rs 15,000 respectively. Seeing this trend, doctors started paying referring doctors Rs 1 lakh in advance and adjusting it as and when patients came in. This menace slowly spread its tentacles all over the medical field, including radiological diagnostics and biochemistry laboratories. For every test ordered, 20 per cent of the bill was given back to the referring doctor. This led to doctors recommending unnecessary tests. The pharmaceutical companies also saw burgeoning business. Acclaimed doctors were given televisions sets, refrigerators, air conditioners and cars depending upon the prescriptions. General practitioners would prescribe unnecessary drugs, and were given returns in cash. A fascinating excerpt from Dr Upendra Kaul's When The Heart Speaks.