Dr Nandlal Manseta, an ENT surgeon in Ahmedabad, charges patients for consultations based on their monthly income rather than a fixed rate. Patients with no income pay nothing, while others deposit cash into a donation box at the clinic.
A sliding scale for care
Under the income-linked fee system, a person earning Rs 1,000 per month pays Rs 10 for a consultation, while someone earning Rs 10,000 pays Rs 100. The fee rises to Rs 1,000 for those earning Rs 1 lakh monthly. The doctor states that a patient’s income of zero means a consultation fee of zero.
There is no requirement to submit salary slips or income certificates to prove earnings. The system relies on patients to state their income honestly and deposit the applicable amount in a box kept at the clinic.
This model removes the barrier of upfront costs for those who may already be struggling financially. While many healthcare systems focus on strict documentation to ensure payment, this approach prioritizes access by trusting patients to report their own circumstances. It shifts the focus from paperwork to the actual ability to pay, which is a rare shift in a system often dominated by rigid billing requirements.
The initiative recently gained wider attention after The Better India shared the doctor’s story on social media. Users praised the trust-based approach, with one commenting that honesty is contagious. Another user noted that those with higher incomes often pay nothing and cause unnecessary trouble, contrasting sharply with the doctor’s model.
