The Indian Medical Association (IMA) has announced certain self-regulation procedures for hospitals and doctors. This comes in the light of the recent incidents involving the lives of a pair of twins, and a 7-year-old girl. The doctor-patient trust in the country, which was already experiencing a downward spiral, has deteriorated further.
Delhi health minister Satyendra Jain cancelled the licence of Max Shalimar Bagh after a premature baby was wrongly declared dead. A police case has been registered against a senior doctor at Gurgaon's Fortis Hospital for allegedly causing the death of the seven-year-old girl admitted to the hospital for treatment of dengue.
Doctors do not have the intent to be the cause for public unrest or loss of public trust as trust is the foundation of a doctor-patient relationship. At the same time patients must understand that to err is human and one incident does not mean that there will be more such cases in future as well, IMA said in a statement.
Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President IMA and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Secretary General IMA in a joint statement, said, "The medical profession is the noblest profession. It is disheartening to see the erosion in trust and we want to make it more transparent. The doctor to patient ratio in India is skewed due to which doctors are under a lot of stress. Doctors are also human beings and not healing angels. Once treatment is administered, the recuperation of a patient depends upon physical and organic factors. It is unacceptable and absurd to victimize the medical practitioner if the patient does not respond to treatment.”
All doctors shall practice with compassion and follow IMA ALERT policy (Acknowledge, Listen in detail, Explain, Review and Thank you). The IMA has also announced formation of an IMA Medical Redressal Commission at the state level (in each state) to engage in social, financial, and quality audits of health care (suo moto or on demand). The commission will have a public man, an IMA office bearer, one former state medical council representative, and two subject experts. The commission shall consider every grievance in a time bound manner. An appeal to the state commission will be heard by the "Headquarters IMA Medical Redressal Commission" which will have the powers to take suo moto cases also. The headquarters shall also suggest reforms in healthcare on periodic basis.
Adding further, Dr Aggarwal, said, “What happened was most unfortunate. However, not all doctors are wrong, and the public must have faith in them. Such errors happen by accident and not intentionally. Having said this, it is also time for the medical profession to introspect and come out with self-regulation procedures. We are often blamed for prescribing costly drugs. From today onwards, all doctors in the country shall choose affordable drugs. We also appeal to the government to come out with an urgent ordinance for one drug-one company-one price policy. Doctors should actively participate in ensuring that no hospital sells any item priced higher than the MRP. No service charges should be added to procure drugs from outside. MRP shall not be dictated by the purchaser.”
IMA further recommends that all doctors should prescribe preferably NLEM drugs and shall promote Janaushidhi Kendras. It appealed to the government to classify all disposables under both NLEM and non-NLEM categories and cap the price of essential ones. Till then all medical establishments should sell the disposables at procurement prize after adding a predefined fixed margin.
Billing should be transparent, and all special investigations should be well informed. Every doctor should ensure that it becomes mandatory on the part of the hospital administrator to give options at the time of admission to choose cost-effective treatment room and treatment (single room, sharing room, and general-ward) and explain the difference in total bill estimates. The treating doctor must explain the chances of death and unexpected complications and resultant financial implications. Once doctors take charge of a patient, the patient should not be neglected. They should look after the patient till discharge.
Emergency care is the responsibility of the state government and the government should subsidize the costs of all emergencies in private sector. Every medical prescription must include counseling on the cost of drugs and investigations. IMA has zero tolerance to doctors indulging in female foeticide. It has zero tolerance to cuts and commissions. Medical establishment should revisit their referral fee system. Billing paid to doctors should be transparent and reflected in the bill.