The only way towards a solution:
A 13 point charter for Doctors
Happy Doctor’s Day!
© Dr. Rajas Deshpande
1. If we want to survive without being exploited and improve healthcare, we must forget all our differences and unite for this cause. We must be able to overcome all personal differences to realize what great strength we are. This is the only solution for ourselves and our dear patients!
2. We must form specialty-wise groups of doctors in each city / state and elect a steering committee that will decide the regional regulations. The charging system for consults, procedures and investigations according to “gradation” of hospitals (facilities, location, quality of advanced care, nursing) etc. should be devised by these regional steering committees alone. State committees should elect a National Medical Steering Committee.
3. The specialty groups in each town must include all consultants from that specialty, and decide the correct fees for consultation, procedures, intensive care, emergency availability and surgeries based upon seniority, qualifications, skill, time, complications and other factors intrinsic to that specialty. This schedule must be binding upon all the small and big hospitals in that region, insurance companies and private practitioners. Sharing fees must be the doctor’s prerogative.
4. There should be no free cases, except those below poverty line and in emergency. Doctors should get tax benefits for every free patient (CGHS /CSMA/ ECHS or BPL in India) treated by them, as per the regional schedule. There should be a regional coordinator for all the Free beds in private hospitals, which are often misused by rich officials. Every consultant must see free patients one day in a month by appointment.
5. Govt. must provide all cost of prescribed medicines, surgeries, equipment, medicines and manpower for the treatment of free patients. This should happen real time, as sometimes the dues are not paid to hospitals by govt. for decades. All existing dues should be settled immediately, so hospitals can provide better care. In patients who cannot afford costly treatments / medicines / surgeries, the funds allotted to the local representative (MLA / MP) may be used by priority. Also allow the pharmaceuticals to pay for the poor patients upon request by the treating doctor.
6. Every hospital must provide free available treatment for all the consultants working for that hospital and their families. All doctors should be collectively insured against: illness, disability, death, accident, loss of job, medicolegal cases and violence induced damage (mental and physical). This must be done at state / national level. The medical insurance companies which earn billions by eating from the doctor’s plates must insure them against all these calamities. Also the corporates and other healthcare giants should be answerable to the regional committees.
7. Any medicolegal case / negligence issues must first be presented to these committees, which will refer it to the national committee, whose decision will be recommended to the courts of law. The current compensation system based upon inequality of “value of life” should be eradicated. All patients are equal, and the compensation value of every life must be the same. If one expects “Indian rates of Treatment”, one must accept “Indian rates of Compensation”. In cases of patients treated free, the govt. should pay the compensation to the patient, otherwise no private doctor will want to treat free patients and invite more legal liability (the misuse of medicolegal cases by the poor and political is an emergency in waiting for future generation doctors). Patients should also have an option of committing complete faith in the doctor and signing a “No Legal Liability” bond, which will make it easier for the doctor to do his best for the patient, unaffected by legal fears. Also, any interference in patient care including intimidation, threats etc. must be punishable by law.
8. Doctors must collectively develop a national medical research funding by compulsory contribution, and start advanced centers for research which are not imprisoned by the lack of initiatives , funding, or intellect. This should be autonomous and purely merit based, with no interference from govt. or anyone else. We should also find practical solutions to accessibility and excellent rural healthcare system. Only we can, govt. never will.
9. There should be revamping of medical education: MBBS in four years, internship, one year bond of rural service, then PG, SuperPG, Fellowship and then practice. This is long enough. All other bonds must be cancelled. Payment structures of all Medical officers, Teachers should be compatible with highest in the govt: IAS / IPS, as these doctors deal with life and death everyday, saving millions. PG exams must be conducted on time, and court interference must be avoided, the decisions of National committees must be final. This will save millions of youth-years of generations of doctors. PG seats should increase every year, there must be unified national payment strategy for PGs. They must also get free food, hostel and internet, and compulsory 8 hours daily sleep time.
10. Doctors must also introspect and improve wherever they are really lacking in the social eye: proper compassionate communication, dignified behavior (avoid this talk of the town when someone overdrinks especially in conferences). We must also start “Positive Connection” strategies with patients, and limit / improve upon the existing crisis of faithlessness by encouraging and rewarding trust. There should be doctor-patient coordination committees in every town to facilitate this.
11. A unified “Paperwork and SOP” National committee of doctors must make such paperwork available on the internet for all doctors to use. The laws governing hospitals must be freed from the innumerable “NonMedico” interferences, red-tapism, corruption etc. roadblocks and must be common all over India.
12. Violence against doctors/ hospital staff must be severely punished. All govt. hospital deans must request 24/7 casualty police.
13. All practicing doctors must receive a compulsory paid vacation at least one month in a year to de-stress, and if the govt. or their own hospital cannot pay for it, let other parties willing to pay be discussed without objections or paranoid suspicions. All said and done, it is extremely stressful to be a doctor. Yearly paid vacation is only human.
This is a sweet dream. But what’s life without a dream? Don’t we wish each other sweet dreams? I mean it this time. Let us work to wake up in this dream. We are a great force, let us overcome our differences and become the Great Doctors who ably carry the Nation’s healthcare like Pros, not slaves.
This seems to be the only way. Happy Doctor’s Day
© Dr. Rajas Deshpande