Cut or commission practice in medicine

Cut pratice or commission practice in medical profession has been there since years. This is no doubt due to craving for earning more money. What is changing recently is the percentage is on the rise, the number of persons giving / taking cut or commission has increased also becoming more and more unethical. I shall touch upon what do I mean by unethical or ethical cut practice in my future postings. Partly it is due to changing technology, newer medical gadgets along with changing life style. The commission is given for minor tests like urine test, consultation to newer high cost investigations and interventional procedures. Many times unnecessary investigations and procedures are done purely for monetary gains both to the performing person and referring doctor. The patients need to know about this and be diligent. It is not possible to guess who is or who is not in to it. It is so rampant that the commission is in fact paid in advance to the referring persons in lump some. The superspecialists and consultants also take commission. The percentage of people who are not into it may be less than 5-10%. The person however skilled or knowledged he may be will be avoided by the referring doctors if he does not "entertain" them. Some doctors maintain a clean note book indicating the name of the patient, amount due, from which doctor / lab etc. Now patients in private practice may not be able to avoid this , at the most can hope that only indicated procedures or investigations are done by a relatively competent person