The leaders of Indian Medical Association [IMA] have attacked Bollywood star Aamir Khan for highlighting the evils in Indian medical system as host in popular TV show Satyamev Jayate. IMA has even threatened to go to court against Mr. Khan .This threat by the doctors has been reported in the media widely. But it is also a fact that this brazen attack against Aamir Khan by some of the devious members of the Indian medical community has been denounced by many ordinary citizens and even some doctors in the country.
The IMA functions under Medical Council of India (MCI) which is a statutory body with the responsibility of establishing and maintaining high standards of medical education and recognition of medical qualifications in India. It registers doctors for practice in India, in order to protect and promote the health and safety of the public by ensuring proper standards in the practice of medicine.
IMA has been caught on “unethical” practice by none other than the MCI in the recent past. The MCI called Indian Medical Association's endorsement of some food products unethical and banned the endorsements. The council asked IMA- an organization of 2 lakh medical doctors as members through more than 1,700 local branches spread all over the country and headquartered in New Delhi to refrain from such endorsements in future. The issue was the IMA’s Rs 2.25-crore contract with PepsiCo to allow Tropicana fruit juice and Quaker oats to use the IMA logo on their packs for three years, ending 2011. The endorsement controversy been raging for two years after Dr K V Babu, an IMA central committee member complained to the MCI on June 6, 2008, that the endorsement violated medical ethics. After protracted proceedings, the National Human Rights Commission served a notice on the association on June 30, 2010. After some confusion on its own powers over IMA, the MCI on August 18, 2010 declared that IMA indeed came under its jurisdiction and served a show-cause notice to the association ''for endorsing food products without valid justification and for a fee” and termed it as an act of violation of the provisions of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002.
Interestingly, in its reply to the MCI, the IMA argued that it had not endorsed the products, but only entered into a MoU with PepsiCo for a 'nutritional awareness programme.' However, the endorsement made the IMA the first professional body of doctors in the world to endorse a food product. Because of this endorsement PepsiCo's Tropicana fruit juice and Quaker oats use the logo of IMA on their packs. But then these were not the only products being endorsed and recommended for consumption by the IMA. IMA has endorsement contracts with other health and hygiene products as well that including Dettol, Lizol (sanitizer), Aqua-guard (water purifier), Pampers (napkins) and Odomos (mosquito repellent).But The MCI had cautioned the IMA and affiliated associations to avoid endorsing food and hygiene products of private companies, since it was a breach of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulation, 2002 provisions which clearly says “Endorsements are against the code of ethics prescribed by MCI and doctors and/or their organizations aren't allowed to promote their products”.
But then that’s not all, the Code of Ethics Regulations, 2002 (AMENDED UPTO DECEMBER 2010) (Published in Part III, Section 4 of the Gazette of India, dated 6th April,2002) of MEDICAL COUNCIL OF INDIA has clearly mentioned other do’s and don’ts for the doctors like:
1. CODE OF MEDICAL ETHICS:
1.1.2 The prime object of the medical profession is to render service to humanity; reward or financial gain is a subordinate consideration. Who- so-ever chooses his profession, assumes the obligation to conduct himself in accordance with its ideals. A physician should be an upright man, instructed in the art of healings. He shall keep himself pure in character and be diligent in caring for the sick; he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions of his life.
1.3 Maintenance of medical records:
1.3.1 Every physician shall maintain the medical records pertaining to his / her indoor patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India.
1.3.2. If any request is made for medical records either by the patients / authorized attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours.
1.4 Display of registration numbers:
1.4.1 Every physician shall display the registration number accorded to him by the State Medical Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money receipts given to his patients.
1.5 Use of Generic names of drugs:
Every physician should, as far as possible, prescribe drugs with generic names and he / she shall ensure that there is a rational prescription and use of drugs.
1.8 Payment of Professional Services:
The physician, engaged in the practice of medicine shall give priority to the interests of patients. The personal financial interests of a physician should not conflict with the medical interests of patients. A physician should announce his fees before rendering service and not after the operation or treatment is under way. Remuneration received for such services should be in the form and amount specifically announced to the patient at the time the service is rendered. It is unethical to enter into a contract of "no cure no payment". Physician rendering service on behalf of the state shall refrain from anticipating or accepting any consideration.
3.7 Fees and other charges:
3.7.1 A physician shall clearly display his fees and other charges on the board of his chamber and/or the hospitals he is visiting. Prescription should also make clear if the Physician himself dispensed any medicine.
6.4 Rebates and Commission:
6.4.1 A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. A physician shall not directly or indirectly, participate in or be a party to act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.
From my personal experiences I can proclaim that many well-earning and ‘so-called’ reputed doctors do not follow the rules or ethics as advised by the MCI. I had lost my 58-year-old father in a case and I believe it was a case of negligence by a renowned doctor. I fought a long legal battle to prove that the doctor was negligent; I know very well that many of the doctors these days hardly bother to follow the MCI guidelines on practice. There are hundreds and thousands of complaints pending against doctors, be it with the Indian Medical Associations (IMA), respective State Medical Councils (MC), consumer courts and equivalent forums. And most of the cases go the doctors’ ways as it’s always a near-impossible task to gather documentary proof against a medical professional. As the doctors are highly educated closely knitted community, it’s impossible to get evidences and testimonies by a doctor against their fellow colleagues despite their “off the record admission” of wrongful treatment or negligence. Therefore corruptions in medical councils, “cut system” in drugs and diagnostics, overpricing of medical services, growing incidents of medical negligence, sex selection services for profits, surgical procedures are a harsh reality one has to live up with to undergo a medical treatment.
In the present scenario the rampant corruption and greed for fast bucks have replaced the sacred vows the doctor’s pledge for, while choosing the medical profession. The recovery of Rs 2 crore from (then) MCI Chairman Ketan Desai as bribe for granting recognition to Gian Sagar Medical College in Patiala for admission of students for 2010-2011 for different courses for which the college did not have the required facilities is evident enough to prove the deep rooted corruption in the system. In another case the CBI has begin investigating former President of Dental Council of India Dr.Anil Kohli for allegedly amassing assets disproportionate to his known sources of income during the period April 1, 2005 to March 31, 2009. It is alleged that the then DCI President received favors from many dental colleges for verification and cancellation of certain institutes. Ultimately he had to resign from the DCI in 2010. It’s evident enough to prove that there is widespread disparity in the health system which is fast decaying in our country.
There is another related case which needs to be mentioned here. When Mr Dinesh Trivedi was the minister of state for health and K Sujatha Rao was the health secretary, the minister openly criticized the secretary and ministry babus for indulging in “red-tapism” and “corrupt culture” Mr.Trivedi’s charge against Rao was that she had created hurdles on way to set up a dedicated portal on health, that was supposed to carry information about top hospitals, doctors and other health-related matter for common people and others.
After taking charge of West Bengal as its chief minister, Ms.Mamata Banerjee made regular surprise visits to hospitals. Although in minuscule level, some positive changes have been noticed in these hospitals. However a recent RTI has revealed that only 9 per cent of the doctors accused of “medical negligence” and “ethical violation” in the state over the last 10 years have been “dismissed” from their services or warned. The rest 91 per cent of the complaints either met dead end or the doctors concerned were let off without even being issued a show-cause letter. A total of 515 cases were filed against doctors in West Bengal [as most of the complaints are declined by the MCI ] in the last 10 years and only 15 doctors have been removed from the council’s list of registered practitioners and another 30 had been let off after ‘warnings’.
As there was none to care about the dilapidated health services in the left regime, West Bengal has seen several exemplary cases of medical negligence and apathy from doctors in both government-run and private institutions which were duly offered cover-ups by the previous Left government. It will take some time for enthusiastic Mamata to put things in order in the government as well as private hospitals.
The gravity of decaying health services can be verified from a reply to the RTI, the West Bengal Medical Council [WBMC] registrar D K Ghosh has furnished that has offered complete details between 2001 and 2010. It says, 171 charges against the doctors or hospitals have been tabbed with ‘not to proceed any further’. 104 cases have been kept pending as ‘cases under consideration’. 61 cases has been ‘closed or dropped’ and for another 25 cases, ‘charges could not be substantiated’. Charge-sheets have been issued in 53 cases but hearing is still awaited. Seven cases are in court and are pending judgment. 27 cases are pending as the accused doctors are registered with other state medical councils.
There are many such similar cases that reflect the plight of those who suffered because of ‘medical negligence’ and are awaiting justice. The Medical Council clearly lost transparency and credibility in their activities. Many families who have lost their dear ones due in such cases of negligence have long been fighting lone battles. But then unless the whole council is redone and the function of the members investigated, speedier justice for the poor victims is highly unlikely. Many prominent government doctors and [members of the WBMC] have resigned from government service after the exit of the Left Front government, citing ‘personal reasons’. But the cases of negligence against all doctors in the past few years must be probed by the new government. At least some cases will certainly be found in which the doctors will be found guilty. Possibly, some high-profile council members will also be caught for having shielded several accused doctors on numerous occasions. We all know that the WBMC failed to cancel the medical registration of the doctors found guilty by Supreme Court in the famous Anuradha Saha death case of 1998.
It is undoubtedly true that the courts and Consumer Forums are not experts in medical science, and must not substitute their own views over that of specialists. But we cannot appoint a murderer to investigate or do justice to a case of murder. We cannot appoint a thief for the same purpose while investigating a theft. The same way we cannot possibly get justice in such cases of medical negligence with the help of medical councils where the executives are medical professionals.
It is also undeniable that the medical profession to a good extent has become commercialized and there are many doctors who depart from their Hippocratic Oath for their selfish ends of making money. It’s true that the entire medical fraternity cannot be blamed for the fault of some doctors. It is also a fact that sometimes despite their best efforts the treatment by the doctor fails- sometimes despite the best effort by a surgeon, the patient dies. But it is also a fact there are some doctors who are earning bad name for the respected profession. The time has come to amend the law and make it more real, satisfactory and unprejudiced as it is against other professionals who work for selfish gains.
Amir Khan is indeed trying to do a good service to the society by pointing out the holes in it. Instead of attacking Mr Khan, Indian medical fraternity should go into retrospection keeping it in mind that counting others’ sins shall not make one a saint and help weed out the fraudulent doctors like ex-Medical Council of India (MCI) head, Dr. Ketan Desai or Dr.Kohli, Ex-Dental Council India (DCI) head, their associates and others, if they desire to re-establish the public faith in their healers….
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