Signed, never seen: Alarm over ghost pathologist scam in accredited, CGHS labs

A doctor’s signature on a diagnostic report is a promise: a qualified professional has examined the findings and owns the interpretation. But what if the name on the report belongs to a pathologist who never saw the sample, the slides or the results?A clarification issued by the National Medical Commission (NMC), a body responsible for doctors’ professional conduct, on October 13 has sharpened that question.The commission said nothing in the NMC Act, 2019, or its regulations bars registered medical practitioners from remotely reviewing and authenticating laboratory, pathology, radiology and other electronic reports using legally recognised digital signatures.The condition is the crux. Remote sign-off is valid only after the doctor has reviewed the clinical information, investigations and other materials needed to form an opinion, and has independently judged the report fit to authenticate.If the information is inadequate, the doctor must hold back until the necessary review is done. “The latest circular is clarifying in which scenario remote authentication can be done. It does not allow ghost signatories or sharing of credentials,” said Dr Anan Jaiswal, a Port Blair-based pathologist who has been raising the alarm in his complaints to various government agencies over the last several months, told India Today.A doctor who genuinely examines the evidence remotely, he stresses, is not the same as a laboratory issuing reports in a pathologist’s name without their involvement.WHEN SIGNATURES MISLEADA pathologist’s job goes well beyond lending a name.Depending on the test, it may involve examining samples, reviewing laboratory findings, interpreting results and checking them against the patient’s clinical picture before a report is released.The “ghost pathologist” allegation is that some diagnostic centres print doctors’ names or signatures on reports without those doctors reviewing them. According to Dr Jaiswal, one pathologist’s credentials may be used across several centres, sometimes in different cities, while the reports reach patients unexamined.The practice strikes at both accountability and safety. A report that was never properly reviewed can mean a missed diagnosis, unnecessary treatment or delayed care.Veterans in India's diagnotic sector, too, say it's been going on without any regulatory oversight.“This malpractice is rampant in the diagnostic industry, and we have been flagging the issue for years,” said Dr Navin Dang, founder and director of New Delhi-based Dr Dang’s Lab and a board member of the National Accreditation Board for Testing and Calibration Laboratories (NABL), a body that accredits diagnostic labs in IndiaHe said the problem needs action beyond what an accreditation body can do alone.CGHS LABS NOT SPAREDThe most troubling part of the complaint is that it does not stop at small, unaccredited labs.Dr Jaiswal’s complaint points to the Central Government Health Scheme (CGHS), which serves serving and retired central government employees and their dependants, too, being scammed by many diagnostic labs.The scheme has 256 empanelled diagnostic centres across 47 cities.Under CGHS rules notified in December 2025, standalone laboratories and imaging centres in covered cities must hold full NABL accreditation to be empanelled. Empanelled super-speciality hospitals must run NABL-accredited in-house laboratories.On paper, these are the labs that should be doing everything right.Dr Jaiswal’s contention is that accreditation has not shielded them: empanelled and accredited centres, he alleges, are also part of the practice of releasing reports under pathologists who have not reviewed them. These claims have not been tested by any regulator or court, and the labs concerned have not been named in the complaint.The stakes are higher here than for a private patient as the labs are paid from public funds. If reports are being authorised without genuine review at centres drawing government money, both patients and the exchequer are exposed.Dr Jaiswal also points to a structural mismatch.India has roughly three lakh diagnostic laboratories, he estimates, of which fewer than 2,500 are NABL-accredited.In Port Blair, he says, three pathologists serve around 40 diagnostic centres. Where qualified pathologists are that scarce, he argues, the temptation to stretch a few signatures across many centres is obvious, and oversight matters all the more.WHAT NABL HAS CONCEDEDDr Jaiswal, a retired Indian Navy pathologist who has worked with corporate pathology chains, has pressed his case over the last several months.The Quality Council of India (QCI), NABL’s parent body, described his demand for a system linking every report to the verified identity of the doctor who authorises it as a “legitimate opportunity for improvement.”It did not, however, announce a new standard or a timeline in its reply to his complaints.Dr Jaiswal has argued that the current system lets technicians or other unauthorised staff use a doctor’s login to release reports.In his letters to the NABL, he has pressed for identity-bound authorisation that makes it hard to issue a report without the designated doctor’s approval, along with explicit safeguards against credential-sharing, reusable signature images in place of real authorisation, and signing in another pathologist’s name.QCI has acknowledged that these practices are already inconsistent with NABL’s safeguards, and that a report authorised by anyone other than designated personnel is a non-conformity under accreditation criteria.NABL’s checks include verifying doctors’ medical council registrations and their stated association with the lab, examining audit trails to establish physical presence, and conducting unannounced assessments. Accreditation runs on a four-year cycle with annual assessments.In an email dated August 6, 2026, NABL’s Assessors Monitoring Committee reminded assessors to verify staff competence and the physical presence of personnel who review, report and authorise results.But whether these safeguards are applied consistently, or can detect borrowed credentials, remains unanswered.WHO ENFORCES?QCI has amaintained that NABL is a voluntary accreditation body, not a statutory regulator. It assesses technical competence and monitors compliance, but cannot take on enforcement functions that belong to government authorities.Where clinical-establishment requirements are violated, action may fall to state governments under the Clinical Establishments (Registration and Regulation) Act, 2010, where applicable.That leaves a gap.The NMC has set the rules for doctors, NABL checks labs on a cycle, and the CGHS pays for the reports. Yet no single body is clearly answerable for confirming that the doctor named on a report actually reviewed it.“Until this gap is addressed, a signature will remain a promise that nobody is checking,” said Dr Jaiswal.- Ends