Why Are ESIC Patients Directed to Civil Hospitals Instead of Private Ones? Seeking Advice on This Issue

Hello Everyone, my name is Puneet, and my question is about forcing someone to receive treatment in a government hospital instead of private ones.

Issue with ESIC Referrals

In my company, a worker went to an ESIC dispensary and asked the doctor to refer him to a private hospital for tests (such as x-rays) for better treatment. However, the doctor did not refer him to a private hospital and instead directed him to a civil hospital. This situation raises the question of why the government charges ESIC contributions from both employees and employers if treatment is available at civil hospitals without the need for ESIC contributions. People are facing various issues in civil hospitals such as fixed test days, timing conflicts, unnecessary crowds (all patients), faulty machines, and more.

I kindly request suggestions regarding this matter.

ESIC Infrastructure and Referral Process

ESIC itself has its own infrastructure of hospitals, clinics, and dispensaries across the country. They have a large number of doctors on the panel who work for ESIC through dispensaries in various areas. ESIC, being an autonomous government organization, can refer to the best possible nearest hospitals, which may include empaneled private hospitals or even civil hospitals in the vicinity based on the non-availability of such facilities with ESIC and on the recommendation of the medical committee of ESIC if so required.

Challenges with ESIC Referrals

Now the problem is of interest, intention, and authorization to recommend or refer treatment to any hospital. ESIC has a medical committee, which includes doctors, specialists, authorized administrators, and officers who have the power to study the case and recommend the best options for treatment and compensations in lieu of treatment.

Having said this, I too agree that it is, however, very difficult to deal with ESIC in similar cases of references and compensation. It's time-consuming as well. However, it is also true that at ESIC hospitals, employees contributing can very well take treatment and approach higher authorities through the proper channel.