The 10 types of freeloaders — how Indian patients avoid paying doctors
After reading my friend, Dr Tejal’s article, I wanted to do a survey to better understand the freeloaders -people who can afford to pay for consultations, but insist on not paying. In particular, I wanted to know their tricks and techniques.
So I made a google form, and posted it on Twitter. This article is a result of that survey. It isn’t super scientific — nevertheless, it gives a valuable insight into the problem. At least for me.
You too can take the survey here
47 people had taken the survey in one day. Majority were endocrinologists, reflecting my close contacts.
Similarly vast majority of those who took the survey were from cities.
Out of 100 patients doctors see, how many are freeloaders?
As you can see the numbers are all over the place, but the median value was 10 % and the average was 13 %.
One in ten patients are freeloaders
Some may see this as cost of business. Others may see this as nuisance.
What techniques do the “freeloaders” use ?
This is the main part of the survey and the responses were interesting. Doctors have poured their 💗out 😄
I coded the responses in Atlas.ti and grouped the codes. This led to a classification of different kinds of freeloaders.
- The friendship freeloader
This type is the commonest. They use friendship as the reason to not pay. Some are friends with you, others are friends with your wife, in-laws or a long lost cousin. There was one case where the doctor felt someone had cultivated ‘friendship’ only for the purpose of free consultations.
2.The Phone/WhatsApp freeloader :
This is the second most common category survey.
This type wants your personal phone number and quietly asks, “is this your WhatsApp number?”. Then they send a 35 page report and asks your ‘opinion’. You are supposed to answer, without taking any fee.
The reasons can be hilarious like,
- I am too busy to come
- I am now in my native place
- I am afraid of COVID , so I can’t come
3.The OnePlusOne Freeloader :
This is the third most common category, along with the referral freeloader.
They ask, “If you don’t mind doctor, can you see my family’s reports too ?”
- The Referral Freeloader
This shares the third spot with 1+1 freeloader. They come in two flavours
- A doctor/relative/friend referred me to you, so I don’t have to you.
- I am a doctor / alternative medicine practitioner and I can refer patients to you, so I don’t have to pay you.
The second flavour is decidedly rare, but as you might imagine, both flavours are bad,.
5.The SecondOpinion /Doubt clearance Freeloader :
This category earnestly believes that second opinion should be given free. Also it thinks, that asking for a doubt, doesn’t count as consultation and therefore a doctor should be wasting his/her time clearing all the doubts a patient may have without taking a free.
6.Already paid / Simple Rx Freeloader :
This type of freeloader would say, “But I paid last month..why should I pay again?”. Another variant is the simple treatment freeloader. They may say
- But it’s just dressing
- But it’s just refill
- But it’s just one minute
- But it’s just a meeting
They insinuate that the treatment you give isn’t complex enough to merit fee, but won’t think why they are in the clinic in the first place if they think it is so simple :-)
One interesting freeloader said this
“Doctor only asked me to come after a month. I feel fine, why should I pay ?”
7.The Fake Sobstory Freeloader :
This type says, “I have already spent all my money elsewhere. So give me free consultation”. Of course, the story if false, but that doesn’t deter this category.
8.The Entitled freeloader :
This category is the most annoying, IMHO. They think serving people is doctor’s ‘duty’ and therefore they won’t pay. The second category is the usual suspects — govt officials, policemen, politician’s relative’s relative etc. Not only does this type of freeloader want free consultation, they want to jump the queue to get the consultation too ! They even throw around their weight in front of clinic front office staff.
**9.The Flattery Freeloader ** :
This type includes probable subclinical psychopaths who are skilled in manipulation. They come in two variants
- Praise you
- Put down other doctors
They might say , “Wow, doctor, you have great bedside manners. You are the best doctor I have seen” or “That other doctor I saw, he’s a greedy bastard. You are a saint”.
10.The Haggler :
This last type doesn’t ask for total free consultation. Instead they bargain. They ask for discounts from front office staff on the pretext that they will bring more patients. One colourful example in the survey said, “I am your wife’s patient. So give me discount” 😜
You might wonder, what effect does all of this have on the doctor ? They feel undervalued. Used. In one incredible instance in this survey, a pediatrician said, “ They send their kids to my home, without permission and I am forced to see them”. The poor pediatrician even said this
I have stopped mentioning to ppl that I’m a doctor and that I’m a pediatrician. If someone happens to know that I’m a doctor then I just tell I work in the lab !!!
Most freeloaders you meet will fit into one of the ten categories. What’s point of categorising the freeloaders ? Classification is one of the fundamental tools in medicine to understand a problem and develop effective solutions. So you can see this as a first step.
If you know any other kind of freeloader, feel free to mention it in the comments. After all, there’s always space for more categories 😜