The interim orders of various high courts in the country on public interest litigations filed by specialist pathologists on the issue of running of pathology laboratories and signing of reports, and the demand raised by various state pathologists associations are bringing into sharp focus the differences of opinion among the medical doctors with regard to Rules governing pathology laboratories.
Pathologists who have approached the courts demand that only a medical practitioner with specialisation in pathology and registered with a medical council, should be allowed to run a pathology laboratory and certify pathological reports. Those medical graduates without specialization in pathology can not be allowed to sign the pathological lab reports.
Further, they demand that all the government PHCs and CHCs should have qualified pathologists in the hospital labs.
Recently the associations of the qualified pathologists and microbiologists in Maharashtra, Andhra Pradesh, Gujarat, Madhya Pradesh and Uttar Pradesh have filed PILs in the respective high courts seeking direction to the state governments to allow specialized pathologists only to run pathology labs and certify the reports. All the courts have pronounced judgements on the associations favour. The UP association of pathologists has prepared common minimum criteria to start a legal pathology laboratory and submitted to government and to the medical council of India, said Dr Jagadeesh P Keskar, Pathologist at Pen-Raigarh in Maharashtra who filed the petition in the Bombay High Court.
The division bench of the Gujarat high court held that the laboratory technicians, being not pathologists, cannot run any laboratory independently. The court also held that the lab technicians could not directly give any report to any patient or any other individual, or to any institution or practising doctor without the authentication of the same by the pathologist registered with the medical council. The court said individual laboratory technician cannot be allowed to run pathological laboratory independently without engaging a pathologist registered with the medical council.
While the association members are defending their side, doctors of other disciplines argue that it is not feasible to appoint qualified pathologists in all the health centres in the country, especially in the rural areas. All the hospitals do not have the posts of pathologists also and therefore to appoint pathologists in PHCs and CHCs is not practicable. Doctors of other disciplines put the suggestion that medical graduates (allopathic) should be allowed to perform a certain set of basic investigations as they have studied pathology and biochemistry in their course.
“Why post graduate pathologist or diploma holder in pathology required to perform basic lab investigations when for managing pyrexia, asthma, and for treating chronic obstructive pulmonary diseases (COPD) no post graduate in internal medicine is engaged? Similarly, for taking sutures of CLW (Contused Lacerated Wound) there does not arise the need of a master in surgery, and for conducting delivery and managing pelvic inflammatory disease (PID), no PG qualified obstetrics and gynaecology is required,” doctors opposing the argument of the pathologists ask.
According to them the Indian Medical Council Act 1956 and professional regulations 2002 clearly says that MBBS is the minimum qualification to practice modern system of medicine. Signing a pathology report is considered a practice of modern medicine. Any qualification other than MBBS or MD pathology/biochemistry/microbiology is not eligible to sign a lab report by law. So, a medical graduate can also sign a pathological report, argues non-pathologists.
The issue became a subject of hot discussion in an online discussion forum of doctors and health officials recently.