Tag Archives: medical council

Wrong Doctor, Wrong Punishments

Wrong doctor, Wrong Punishments
© Dr. Rajas Deshpande

“There are many wrong things going on in our profession, and I insist that you must write about them too. Working at a tertiary care center, I see many patients wrongly investigated and treated” my senior professor said on phone last week.
I did not argue. He was correct. He is one of the most brilliant and dedicated superspecialists I know, and I consider myself fortunate that I studied and worked under him. I just explained to him that my page was dedicated to highlight the good side of this profession, as there are umpteen critics but rare sources that speak about the good.
“But we must evolve. It is known that we are humans and there will be mistakes. Many patients die due to medical mistakes too. If we are open about the mistakes, even the law takes a lenient view. Most of the hospitals stand by the doctor if the mistake is honestly reported in time. Many patients understand that too” he said. © Dr. Rajas Deshpande

I disagreed with him then, but as I worship his acumen, I decided to meditate about this.

Yes there undoubtedly are cases we see almost every day, wrongly investigated and treated. Underqualified, wrongly qualified and even unqualified doctors treat patients according to the best of their knowledge, but unfortunately intention alone is not enough to treat a patient correctly. Political support ensures the safety and proliferation of such practices. Although we all know the basic managements, the patient is not then offered the best.

That apart, sometimes, treatable illnesses are missed just because some general practitioners/ paraclinical practitioners/ crossover practitioners who think they know everything never take a second opinion of an expert in the respective field. Many a times though, it is the patients who choose to stay with the least charging practitioner, never knowing their treatable conditions are worsening all the time that they think they are saving money. The practice of obtaining a second opinion is quite healthy and must be encouraged at all levels, although there are some patients dissatisfied with even the twentieth opinion.

Hospitals without the requisite expertise (qualified experts or technology) to treat certain category of patients and conditions often freely admit any patient and treat based upon incompletes skill and resources (under the legal protection of emergency treatment clause). So long as it is cheap, the patient seldom questions treatment. Once they are referred to the higher center, the trust level sinks as bills increase. © Dr. Rajas Deshpande

This often results in a treatable condition worsening to a stage of untreatable emergency. All the anger against this is usually borne by the last doctor / hospital treating the patient and trying to help in their most difficult situation.The non availability of enough staff at many government-run set-ups is never questioned.

Let us consider that a doctor or a hospital has committed a mistake, and the hospital wants to honestly report it to the patient and apologise, then to legally compensate the patient.
It will be wild daydreaming if anyone thinks that our society is presently mature to handle this.

In India, a doctor is presumed guilty of almost every death or failure of improvement in patient’s health. Even a patient who has abused his / her body, not followed any healthcare instructions (smoking, drinking, diet, exercise, reducing work and stress etc., not taking medicines as advised and self treatment) still thinks he is qualified enough to blame the entire medical profession for his / her failing health.
Relatives who have never bothered to know if the patient took his / her meals or medicine in time, procrastinate taking the patient for timely check-ups suddenly become “google qualified lawyers against healthcare system” once something goes wrong. © Dr. Rajas Deshpande

Blatant advertisements of “complete health check up” including hundreds of unnecessary tests are seen everywhere, and the word “concession or free” is probably the sexiest lure in healthcare industry today. Here, the patients or relatives do not mind their blood being drawn, being exposed to unnecessary radiation, or being charged for unnecessary tests just because it is all cheap / concessional. There are umpteen examples where the patient google searches about symptoms, gets the blood tests, MRI and many other unnecessary tests, and then visits a qualified specialist.

Only the qualified doctor advising the necessary tests is labelled an unholy, profitmaking business.

Suppose the doctor declares his / her mistake. Who guarantees that it will be investigated in secrecy, only legally tried by a qualified team of medically updated judges, and if at all the doctor is guilty, then the legal punishment alone will be implemented, guarding the security and the reputation of such a doctor? In a country where the media as well as judiciary is often tainted, how safe is it for a doctor to honestly admit his / her mistake? © Dr. Rajas Deshpande

In a single day, the media will bring down the entire practice of alleged doctors and a reputation hard earned over decades . The mobs with different lawless communities will vandalise their hospitals. The police is unable to always stand by truth, given the influences that gag and tie them. The judiciary will come in later at a time when the doctor’s life will be scarred and damaged beyond repair. Not everyone among the doctors is expected to have a shameless mind structure to go on despite disrepute. Corporate hospitals very easily disown doctors if their reputation is threatened.

Just as there cannot be any compensation of a lost life, there also is no compensation for a doctor’s lost reputation. A doctor’s reputation is his professional life. So long as the society does not offer protection from mobs, media and wrongful allegations in expectation of free / cheap but accurate scientific healthcare, the doctor will never feel safe enough to come out with his / her mistake.

A trial with ensured privacy and security, guarded information to the media in correct format accepted by the court, and very strict guidelines about proceedings in such cases will alone help doctors come out in open about their own mistakes, and also against the malpractices in their own profession.

Till then, we are all at the mercy of the maturity of our politicians, media and society.
© Dr. Rajas Deshpande

Maharashtra Medical Council (MMC) Elections: An Opinion

Maharashtra Medical Council (MMC) Elections: An Opinion
© Dr. Rajas Deshpande
I can shut up. In that case please do not read this post.
Or I can open up my heart.

At the outset, I am not writing this for any panel.
Many panels have been formed. While the IMA panel has the “apolitical” background so essential for the medical fraternity, it has in the past given jitters to medical practitioners by making controversial statements to the media against its own members. It has the benefit of a history of impartial work for allopaths, but needs to reaffirm a stronger face and stand in favour of the practitioners rather than working for limelight.

While apolitical is the best choice, it also lacks the essential strength to garner the support of the lawmakers (read political will), hence the panels associated with political outfits have an advantage. But the same rule applies in the negative: that the chosen candidates from such panels will have a tough time standing against their own party should it try and implement some idiotic populist rules / laws. Only those candidates who have respect and backing of the strongmen in their supporting party will make a difference.

In a society with predominant negative opinion of the medical profession, and amidst media largely interested in finding trivial faults of the medical practitioners and blowing up tiny issues, the MMC members must stop making statements that tarnish the image of this troubled profession, and pretending “holier than thou” to others.
A unified effort to come out strongly to protect the allopaths from the assault of various political / social / federal forces which want to enslave this profession to be able to use it as a tool to impress the masses to hide their own inefficiency, by making populist statements and laws has become the need of the hour. Any candidate who stands for this is the right candidate we need in MMC.

While credit point system is an ultramodern and justified idea, its marriage to a slow and inadequate system / execution created the necessity to attend unnecessary CMEs, waste precious holidays and increase (hidden) dependence on the pharma sector for travel, food and stay. In the era of hi speed internet and satellite meetings, the very idea of physical presence away from the practicing hospital or home is ridiculous. This idea should have been implemented only when the MMC acquired ability to practically provide online relevant CMEs for every specialty. The whole process of thousands of doctors traveling out for conferences for which the patient ultimately pays does not really achieve the expected “learning” benefit. Think of the millions of doctor-hours and rupees wasted.

The general issues must be treated as primary points upon which each candidate must clarify his / her stand without ambiguity and party policy:
*Crosspathy,
*Everyone (hospitals, quacks, alternative pathies and TDH) being allowed to advertise except the registered and qualified allopath,
*The non-accountability of medical ethics / practices at some hospitals, the exploitation and harassment of qualified doctors by some hospitals,
*The fake clinical trials, and PG diplomas/ degrees
*The open defamation or suspension-without-enquiry of any allopath against whom complaint is lodged by revengeful patients / relatives / politicos
*Fighting the unfair draconian clauses in the regulations like PCPNDT at all levels
*Provision of free legal backing to registered candidates
and filing defamation suits against false complainants against medical professionals
*Fighting for the autonomy of the National Medical Commission and its governance by Medical specialists and Judges only, without political interference / controls.

The contesting candidates must also comment about the specialty specific issues like those of Pathologists, Radiologists, OBGYN, Intensivists etc.
Human rights regulations about working hours of doctors including residents, PGs should be defined and implemented by the MMC, this alone can encourage the govt to fill up empty posts at medical colleges and hospitals, and to stop overuse of existing staff.

Renewal of Medical teachers’ and Medical Officers’ registrations should be automatic: teaching should get credit points, and so should working in rural areas.
My appeal will be to vote for individuals rather than panels. We must choose candidates who have done significant constructive work for the fraternity. Many of my dear friends are contesting this election from different panels, and I know candidates from every panel who have spent years adding to the grace of our profession, fighting for its dignity.

The last thing medical professionals can afford at this moment is a fraternity divided further. Let the differences among the panels NOT be the cause of differences within the fraternity.

Dr. Pradeep Benjarge is the only one name I will mention in this post, because he is an independent candidate, we have all witnessed his relentless struggle over a decade to fight injustice against medical professionals and hospitals. I have reserved one vote for him.

There are some candidates who have worked hard over past many years to safeguard the interest and image of medical profession. Their work will of course reward them. There are some newcomers who want to change the existing uncertainty and insecurity among the allopaths. My sincere best wishes to them too.

One request: whichever panel they contest from, the candidates must work together for the fraternity rather than carrying the “panel title” to the MMC. We need strong fighters who will unite like soldiers of different religions, to protect the nobility of their profession. Doctors can be excellent politicians (and devastating often), but this ground is not for the show of might.

MMC should be a round table of scientific minded intellectuals with strong integrity.

My best wishes to every candidate! May the best men and women win to the “MMC Panel”.
© Dr. Rajas Deshpande
Please feel free to share.

Naked Cavemen, Einstein and Calvin Klein

Naked Cavemen, Einstein and Calvin Klein
© Dr. Rajas Deshpande
Lower courts give judgements. Higher courts change them. Higher courts give judgements, other benches change them. Government fights with courts. All of them work less than 8 hours (few exceptions) and have sumptuous vacations. Judges without medical training will decide about medico-legal cases. But any of them do not require exams to improve performance or to deliver better in spite of huge backlogs. © Dr. Rajas Deshpande
Almost in every government office, in most departments controlled by them, bribery is a rule rather than exception. Piles of files do not move, pensioners die without pension and farmers commit suicides. But the concerned authorities who work 8 hours per day do not need any corrective courses or exams to assess their performance, to compare where the developed world is today.© Dr. Rajas Deshpande
In most of the healthcare facilities run by governments, there are severe deficiencies: no appointments of doctors, no proper salaries, no facilities or backups, no security, and worst of all, no vision. But the people who are responsible for making these policies do not need any training, assessment or exams. The very people who want youngest generations of doctors to provide world class medical services to rural India do not want to change their decade old failing policies.© Dr. Rajas Deshpande
The thousands of practicing Babas, Gurus, Quacks who are officially seen tied up with the highest of the land and bash the allopathic and scientific medicines spreading poison in the society do not need any exams to preach or practice. The lawmakers who do not ban tobacco, alcohol, helmetless driving, the people who eat unhealthy and mistreat themselves or family do not need any exams. The transport offices that issue driving licences to unfit drivers do not need training or exams.
We see many military men and out of respect treat them free. They are so patriotic that they seldom expect anything in return from the country. But they often relate how bad the conditions are for them and their families. There is a crop of people who quote the military sacrifices as if it was their own credit! Those who are responsible for the upgradations in facilities for the military personnel do not still need any exams.© Dr. Rajas Deshpande
There are deaths due to hunger and malnourishment. But the ones who are in a position to change this by making right laws do not need any exams. Illegal buildings are erected, labourers die when they collapse, but the concerned professionals do not need exams or assessment.
547 extremely responsible and respected representatives who waste the public money in daily crores over a month due to ego issues, not being able to come together in the interest of the nation to resolve issues, blaming it all upon each other do not need any exams to assess their performance.
But the actual allopathic doctor, who has stood highest merits in all exams, stayed on the top of the competition to earn his / her degree late in life, all of whose exams had 50 percent as passing limit as opposed to 35 percent in all other professions, who has sacrificed family life, sleep and food for over 10-15 years just for learning, who works almost 24/365 and solves health problems on a daily basis, updates his / her knowledge with CMEs, stays in touch with the latest and delivers it to the poorest of the poor with equal affection, carries the country’s failed healthcare upon his / her shoulder is not good enough for them! Now they want the allopath to appear for exams lifelong, suspecting that his / her knowledge is still not enough good for them, even after the CMEs.© Dr. Rajas Deshpande
If the millions of doctors are forced to give exams repeatedly all their life, they will happily do so (for they are not afraid of exams). But this will take away billions of doctor-hours out of service (exam leaves) in an already failing healthcare system, will tax the patient more, will open up new channels of corruption and another universe of chaos will add itself to India. Who cares? The ruling mood seems to be ”Patients will die, patients will pay”.
The current CMEs are world standard, do not tax patients, and enough effective. But our system seems to want “better than the developed-world class of doctors”.
This is like the stone-age naked cavemen asking Einstein and Calvin Klein to appear for yearly exams to stay updated for serving them.
© Dr. Rajas Deshpande
PS 1: The nicer you are, the worse your troubles. Doctors must unite upon an apolitical platform to fight stupid laws being proposed.
PS 2 For those who are not able to think beyond medical malpractices and corruption, please make an effort to understand that there are other issues in medical practice, and this post is not about money.
Please share unedited.