Some Ugandan doctors are allegedly receiving commissions from foreign hospitals and medical tourism companies for referring patients abroad for treatment, according to an investigation by New Vision.
An unnamed doctor quoted in the report said private hospitals in India, the United Arab Emirates, Egypt and Turkey have recruited Ugandan medical consultants who allegedly receive commissions of between 5% and 15% of a patient’s total treatment bill for successful referrals.
The referrals reportedly involve conditions including heart disease requiring surgery, eye conditions, kidney-related treatment, hernia repairs and joint procedures.
The costs of treatment abroad can range from about Shs40 million to Shs400 million, according to the report.
The allegations raise questions about whether financial incentives are influencing decisions on where Ugandan patients receive treatment, particularly where some of the procedures are available locally.
The Uganda Heart Institute, for example, provides specialised cardiac services in Uganda. The country’s health sector has expanded its capacity for complex procedures, although some patients continue to seek treatment abroad.
Uganda has previously raised concerns about the growing cost of medical tourism. In 2014, the Ministry of Health estimated that the country was losing about $73 million (then approximately Shs278 billion) annually through treatment abroad. In 2024, the Uganda Medical Association called for greater regulation of medical tourism, arguing that some complex conditions can already be managed by Ugandan doctors and facilities.
The practice of paying doctors for patient referrals would also conflict with Uganda’s professional medical ethics rules.
The Uganda Medical and Dental Practitioners Council’s Code of Professional Ethics prohibits practitioners from paying commissions for recommending patients. It also prohibits sharing professional fees with people who did not participate in the service for which the fees are charged and receiving consideration from a particular facility in return for professional activities.
The Council is mandated to enforce professional medical and dental ethics and exercise disciplinary control over practitioners.
Concerns about doctors acting as intermediaries for foreign hospitals are not entirely new. In a 2019 report, Uganda Radio Network quoted senior cardiologist Dr Tom Mwambu of the Uganda Heart Institute saying some doctors had become brokers who earned commissions for directing patients to hospitals in India, including in cases where procedures could be performed in Uganda.
However, the latest allegations would require verification from the doctors, hospitals and medical tourism companies involved before individual practitioners or facilities can be identified as participating in the practice.
The issue leaves a difficult question for Uganda’s health system: when a doctor recommends treatment abroad, is the referral being driven by what the patient needs—or by what the doctor stands to earn?
