A study of more than 20,000 consultations found that nearly 44 percent of patients advised to undergo surgery received a different recommendation after seeking an independent second opinion.
A study by Navi Mumbai-based medical second-opinion platform MediAngels has raised concerns about the number of surgeries being recommended to patients in India, finding that nearly 44 percent of patients advised to undergo surgery were later told by independent specialists that the procedure was unnecessary.
The findings, reported by TOI, were based on an analysis of more than 20,000 consultations conducted by MediAngels over a two-year period. Of the 12,500 patients who had been advised surgery by their primary doctors, nearly 44 percent received a differing opinion from specialists consulted through the platform.
According to the study, the highest discrepancy in medical opinions was recorded in cardiac procedures, where 55 percent of cases received a recommendation different from the initial advice. Knee replacement surgeries and hysterectomies followed at 48 percent, while infertility-related procedures showed a 45 percent discrepancy rate.
Dr. Debraj Shome, surgeon and founder of MediAngels, said the data indicated poor adherence to surgical guidelines across multiple specialties.
“We found that the discrepancy in opinions was highest in heart problems at 55 percent,” said Shome. “We have doctors seeking opinions if they themselves are asked to undergo surgery. This says a lot about the trend.”
The issue of unnecessary surgery is not unique to India. Similar concerns have emerged internationally, including reports in the United States questioning the frequency of knee replacement procedures. In India, concerns over medically unnecessary interventions have periodically surfaced in connection with government insurance schemes and private healthcare incentives.
The study highlighted several examples in which second opinions resulted in patients avoiding major procedures. In one case, a patient advised to undergo immediate cardiac surgery was later informed by independent specialists that his symptoms stemmed from an orthopedic problem rather than a heart condition.
Healthcare ethicists say the findings warrant closer examination of financial incentives within the medical system.
“This data shows that we have reason to be concerned,” liver surgeon Dr. Sanjay Nagral, a member of the editorial board of the Indian Journal of Medical Ethics. “Everything in Indian healthcare is increasingly getting monetized. This is an indicator of that malaise.”
Some medical professionals argue that growing commercialization may influence treatment recommendations. One surgeon quoted anonymously described the phenomenon as a reflection of “market medicine,” suggesting that doctors in some private healthcare settings may face pressure to generate revenue through procedures and admissions.
Critics argue that concerns about unnecessary procedures are part of a broader debate over transparency, patient rights, and accountability within the healthcare system.
Concerns about patient exploitation have surfaced in several high-profile cases over the years. In a case reported by TOI, 14-year-old Prashant Sharma was admitted to Delhi’s Batra Hospital in 2006 after developing fever and typhoid symptoms. After his condition deteriorated, he was placed on a ventilator and remained on life support for weeks before being declared dead. According to findings later cited by the Delhi State Consumer Redressal Commission (DSCRC), the family was not informed that Prashant had shown “no clinical features of brain stem activity,” despite observations recorded by the treating neurologist. “They were never explained the role of a ventilator in the case of a patient who is ‘brain dead’,” said N P Kaushik, judicial member of DSCRC.
The commission observed that ventilation was discontinued only after the family exhausted its financial resources, and compensation was subsequently awarded to the family.
Concerns over fraudulent practices have also prompted regulatory action under government-backed healthcare schemes. In 2025, the Union government informed Parliament that authorities had taken action against hospitals accused of irregularities under the Ayushman Bharat health insurance programme. According to information presented in the Lok Sabha and reported by The Hindu, 1,114 hospitals were de-empanelled, penalties worth ₹122 crore were imposed on 1,504 hospitals, and 549 hospitals were suspended for fraudulent activities reported by states and Union Territories.
Cases involving illegal organ trafficking have further highlighted vulnerabilities within parts of the healthcare system. One such case involved Sangeeta Kashyap of Kanpur, who alleged that she was lured to Delhi in 2019 under the promise of employment and asked to undergo a medical examination.
“I realised that something was amiss. Later during the week, when I was taken to a hospital, I overheard people describe me as a kidney donor. I panicked and raised a hue and cry at the hospital. I insisted that I be sent back home immediately. They packed me off to Kanpur and I thought the worst was over,” she recalls.
Suspicious conversations she overheard during the process prompted her to flee and approach the police. Subsequent investigations reportedly uncovered a large organ trafficking racket involving multiple individuals, including medical personnel and other facilitators.
While such cases involve allegations far more serious than disputes over treatment recommendations, they have contributed to wider public concerns about transparency, accountability, and patient trust within parts of the healthcare system.
At the same time, experts caution that differences in medical opinions do not automatically indicate malpractice. Nagral noted that advances in medicine have created multiple treatment options for many conditions, meaning patients may receive different recommendations depending on whether they first consult a surgeon, physician, or specialist in non-surgical therapies.
International healthcare systems have increasingly incorporated second-opinion mechanisms to address such concerns. In countries such as the United Kingdom, multidisciplinary tumour boards often review treatment plans collectively, while some U.S. states require additional medical opinions before certain surgeries can proceed.
The issue has also drawn attention from global health experts. During a World Bank deliberation in 2014, researchers warned that “medical overuse” was emerging as a significant challenge in India, particularly as insurance coverage expanded access to healthcare services.
As healthcare costs continue to rise and more Indians gain access to medical insurance, experts say greater transparency, stronger clinical guidelines, and wider use of independent second opinions may help patients make more informed decisions about surgical treatment.
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