Straight from the Heart The time has come to show our solidarity to the cause of the medical profession Dr KK Aggarwal Padma Shri & Dr B C Roy National Awardee National President IMA, Vice-President, CMAAO Dear Colleague The time has come to show our solidarity to the cause of the medical profession. When I began my tenure as IMA National President, I gave a slogan "IMA 1 Voice" and I feel that today will show the entire nation that IMA does speak in “One voice”. IMA has 8 lakh practicing or serving medical doctors in the country. One percent of this is 8000. According to the 100th monkey phenomenon, 1% of the collective consciousness of people decides what 99% will do. Sixty thousand IMA members have already signed the petition, which is 7.5% of medical professionals … way above the required critical mass (of 1%). This shows that the entire medical profession is concerned about the atrocities on the profession and that they are not allowed to work in a fearless atmosphere. All these years we have been practicing individual patient-centric medicine using all social determinants of health and prescribing drugs, investigations and deciding on a line of treatment based on the interests of the individual patient. But now we are being forced to follow outdated standard treatment guidelines formulated by “experts” with possible no experience of working in the private sector. We are being forced to write drugs, the quality of which will be decided by pharmacists and follow a line of management based on non-practical guidelines. We are also being forced to charge a fixed fee decided by the government. This ignores the seniority and acumen of the doctor. We are also given targets by many private hospitals and government setups. We joined MBBS with the understanding that medicine is a noble profession and hospitals are temples of healing where the sick come to get relief from pain and misery. Medical doctors have always been regarded next to God. We never think of temples as a place of criminal activity. Then why are doctors being accused of criminal action? Involving police in any case of dispute or death is now becoming a routine procedure. It is the duty of a doctor to provide treatment and work in the interest of the patient. Death of a patient does not always mean negligence. Then why are Section 304 and 304(a) even being considered by the police directly? The answer to all this is a ‘single window accountability’. Unless the State Medical Council or the Medical tribunal feels that there is gross medical negligence, section 304/ 304 (a) should not even be considered. It is common knowledge that under Section 88 of IPC, nothing is a crime if done in good faith. Even culpable homicide not amounting to murder, is not applicable to doctors as it is not our intent to harm a patient nor do we carry out a procedure without informing the patient about its possible side effects. There are many more issues enlisted below, with other possible suggestions. Issues Suggestions 1 Criminal prosecution of medical negligence and on clerical errors is not acceptable Criminal prosecution of medical negligence and clerical error should be an exception and not a routine. 2 Capping the amount of the compensation awarded under Consumer Protection Act (CPA) Compensation should not be based on the income of the person but on the formula used by DCGI in a Clinical Drug Trial. 3 Professional autonomy in treatment and prescriptions Safeguarding the interest of the patient by practicing medicine based on social determinants of health and patient-centric decisions. 4 Stringent central act against violence Universal central act against violence similar to that has been enacted in 18 States 5 No unscientific mixing of systems of medicine Ayush should be strengthened in its own field and not allowed back door entry in modern system of medicine. 6 Empower MBBS graduates UG seats equal to PG seats and bring back the concept of family doctors. 7 Biomedical Waste Policy & safeguarding the interest of small nursing homes. Doctor-owned small nursing homes should get due exemption. 8 One drug - One company - One price Price of generic-generic, generic-trade, generic-brand from one company should be the same. 9 Implement inter- ministerial committee recommendations in six weeks This has already been delayed by 2 years. 10 Single window accountability State Medical Council or a Medical Tribunal is a solution. 11 Single window registration of doctors and medical establishments This will reduce the cost of treatment and can be undertaken by the Health Ministry. 12 No to NMC: Amend Indian Medical Council (IMC) Act to maintain professional autonomy No regulatory mechanism can run with predominant nominated body. 13 Uniform final MBBS exam instead of 'NEXT' A uniform final MBBS exam will ensure quality. 14 Uniform service conditions for doctors & faculty This should be at a national level. 15 IMA member in every government health committee Nirman Bhawan can allocate a room to IMA for fruitful functioning. 16 Central anti-quackery law Every citizen of India has a right to receive quality and safe health care. 17 Reimbursement of emergency services for private sector Emergency services are the responsibility of the State but they have no resources. 18 25000 family medicine PG seats We need more family physicians; this can be undertaken by MCI or NBE (DNB) 19 Health budget between 2.5-5% in the coming year for universal health coverage This is to provide universal health coverage. 20 Aided hospitals and retainer ship in general practice This will provide subsidized services to the middle class. The time has come for all of us to give a last push to Dilli Chalo movement. I request all those who have not able to reach Delhi, to show their solidarity by signing the petition of IMA at http://ima-india.org/dillichalo/petition or mark your digital presence today 8-2 PM on IMA website http://ima-india.org/dillichalo. You can also listen to the National Presidential address from 11:30 AM to 12 noon along with a live webcast of all the deliberations. You will get a SMS with a link, you just have to click on it and listen. Looking forward to have all of you under the "IMA 1 Voice" platform.