Friday 28 April 2017

Myths and Facts of Medical Practice - From WhatsApp Group

Please Forward this message to all Non-Medico Persons on your Contacts.

''MYTHS AND FACTS OF MEDICAL PRACTICE''

*1. MYTH - MEDICAL PROFESSION IS A NOBLE PROFESSION*..
    FACT- EVERY PROFESSION, WHETHER OF A TEACHER, SOLDIER, TAILOR OR SHOPKEEPER, IS NOBLE, IF DONE WITH SINCERITY AND INTEGRITY. 

*A CARELESS DOCTOR CAN KILL ONE**, A CARELESS  DRIVER CAN KILL DOZENS, A CARELESS ENGINEER CAN KILL HUNDREDS..

*2. MYTH - AS IT IS A SERVICE TO HUMANITY, DOCTORS SHOULD NOT RUN AFTER MONEY*.
    FACT - MONEY IS AN IMPORTANT MEASURE OF SUCCESS. RUNNING AFTER IT IS NOT GOOD FOR ANYBODY, BUT EARNING MORE MONEY BY DOING MORE WORK IS NOT A MORAL CRIME.
AND ALL WHO ADVISING DOCTORS, THEMSELVES RUNNING AFTER MONEY, AREN'T THEY?

*3. MYTH - DOCTORS MUST BE HUNDRED PERCENT HONEST.*
    FACT-  DOCTORS DO NOT COME FROM MARS OR VENUS. IF SUPREME COURT JUDGES OR ARMY GENERALS CAN BE CORRUPT, SO CAN A FEW DOCTORS. AS A CLASS, THEY ARE STILL BETTER THAN POLITICIANS, BUREAUCRATS, LAWYERS, POLICE OR PSU ENGINEERS.

*4. MYTH - MOST OF THE TIME, DOCTORS DO NOT UNDERSTAND THE DISEASE AND WRITE UNNECESSARY AND COSTLY DRUGS AND ADVISE TESTS AND TREAT ON A TRIAL BASIS.*
     FACT- DOCTOR PATIENT RELATIONSHIP IS BASED ON TRUST, IF YOU DO NOT TRUST YOUR DOCTOR, GO TO ANOTHER ONE. MEDICAL SCIENCE IS A LIFE LONG LEARNING PROCESS, AND ALL TREATMENT, TO SOME EXTENT IS BASED ON TRIAL AND ERROR. THE SAME MEDICINE, WHICH WORKS FOR ONE PATIENT MAY NOT WORK ON ANOTHER. 
SECOND, THE RESPONSIBILITY OF PROVIDING QUALITY DRUGS AT AFFORDABLE PRICES LIES NOT WITH THE DOCTOR, BUT WITH THE STATE AUTHORITIES, JUST LIKE PROVIDING FOR BETTER ROADS, UNADULTERATED QUALITY FOOD AND DAIRY PRODUCTS, UNINTERRUPTED POWER AND WATER SUPPLY ETC AND ETC. LIKE CLOTHS, CARS AND MOBILE PHONES, COSTLY DRUGS ARE GENERALLY BETTER THAN CHEAP ONES. HOWEVER, IF THE GOVERNMENT MAKES IT MANDATORY TO WRITE GENERICS, IT SHOULD ENSURE QUALITY AND THE CONSEQUENCE OF POOR/NON  EFFICACY SHOULD NOT BE BLAMED ON DOCTORS.
THIRD, TESTS ARE DONE FOR PATIENT’S OWN SAFETY. JUST LIKE WEARING A HELMET OR SEAT BELT, INVESTIGATIONS INCREASE THE SAFETY. MOST OF THE DOCTORS IN INDIA ARE TRAINED TO WORK ON CLINICAL HUNCH AND COMMON SENSE AND NOT RELY TOO MUCH ON TESTS, AND ADVISE MUCH LESS TESTS THAN WHAT IS ACTUALLY WRITTEN IN THE BOOK OR DONE IN THE DEVELOPED WORLD.

*5. MYTH - TREATMENT COSTS ARE INCREASING IRRATIONALLY*.
     FACT-  COMPARED TO WESTERN WORLD, TREATMENT COSTS IN INDIA ARE STILL VERY LOW, AND MANY FOREIGNERS ARE COMING HERE FOR THIS REASON. AND IT WOULD BE WORTHWHILE TO THINK ABOUT ANY OTHER SERVICE OR PRODUCT WITH AS RAPID ADVANCEMENT IN TECHNOLOGY AND EQUIPMENT AS MEDICAL SCIENCE, WHOSE COST IS NOT INCREASING

*6. MYTH - DOCTORS ARE NEXT TO GOD*..
    FACT - DOCTORS ARE AS HUMAN AS CAN BE. THEY ALSO GET TIRED, FALL SICK, HAVE FAMILY COMMITMENTS, GET UPSET AND STRESSED SOMETIMES AND CAN SUFFER FROM ALL THE FRAILTIES OF A HUMAN BEING. IF ANYONE WANTED TO BE TREATED BY GOD THEN THEY CAN VISIT THE TEMPLE..

Monday 24 April 2017

BMJ Editorial on Ketan Desai - Time for an Overhaul at the World Medical Association (WMA)

Please read about the man who runs Medical Council of India (MCI) through proxy using his cabal. No wonder that there has been absolutely no cleaning up of the mess that exists in the Indian Medical Education Business. Neither MCI nor Indian Medical Association (IMA) has shown any steps at dealing with the continuing CORRUPTION in Indian Medical Education Business. No one is bothered about improving the Indian Medical Education Standards. Instead, cosmetic and coercive measures are being forced upon the Faculty and staff of Medical Colleges, to divert attention from the real issues of CORRUPTION and misgovernance continuing over a decade.

The Polity vs Bureaucracy debates either falls short or compliments, when it comes to Ketan Desai's profile.

http://ddatta16.blogspot.in/2017/03/polity-vs-bureaucracy-ruined-and.html?m=1

Please see this BMJ Editorial to understand the context


The contents of the article are pasted below.

Time for an overhaul at the World Medical Association.

Serious questions must be asked about its standards of governance

David Berger GP and emergency medicine doctor, Kalang, NSW, Australia

On 21 October 2016 Ketan Desai began his one year tenure as president of the World Medical Association. The WMA is formed and funded by 111 national medical associations and describes itself as “an organization promoting the highest possible standards of medical ethics.”1 
The incumbent president, however, is a controversial figure who has been charged with corruption in a Delhi court.2-4
Desai has not been convicted of corruption, denies all charges against him, and must be allowed the presumption of innocence.
He has been exonerated in a number of previous corruption cases, and in one recent case in Lucknow the Uttar Pradesh
government did not provide sanction to proceed (decision of Lucknow High Court in possession of author and The BMJ).
The current case in Delhi dates back several years, and Desai spent some months in prison on remand for this case in 2010. 5-10
At that time the ethics committee of the Board of Governors in Supersession of the Medical Council of India, the body that registers doctors to practise in India, debarred him “from practicing medicine and participating as a doctor in a medical
conference anywhere, representing doctors in any medical council, conference and association” (document in possession
of author and The BMJ). The council has subsequently refused to release information about his current registration status and has obtained a High Court stay against a January 2017 Central Information Commission order to release this information. One may ask why the Medical Council of India is so reluctant to release information relating to the registration status of one of India’s leading doctors and now president of the WMA.11 12
Desai’s appointment has dismayed campaigners against healthcare corruption.13
The uncertainty created by the ongoing court case undermines his credibility as a global custodian of medical ethics. The WMA was warned repeatedly of the allegations against Desai and of the ongoing court action (Kunal Saha, personal communication in possession of author and The BMJ). But as recently as October 2016 the WMA was still insisting that there were no cases pending against Desai. “To our knowledge there are no charges against him—they have all been dropped,” Otmar Kloiber, WMA’s secretary general, was quoted as saying in an article on the News Minute website.14
The article continued: “Asked on what basissuch an assessment was made he [Kloiber] said, ‘There is no proof. Send me proof - and I don’t want to see newspaper clippings of which I already have many.’”14
Consulting an Indian lawyer or even a brief investigation of publicly available court documents would have revealed factual evidence to the contrary, but the WMA apparently decided against undertaking any independent investigation and chose instead to rely on the word of the Indian Medical Association, which was supportive of Desai. 
In 2014, however, an investigation by the Medical Council of India’s chief vigilance officer (who subsequently claimed he had been harassed by the council for his drive against corruption.15) took the matter seriously enough to recommend that it be referred to the Ministry of Health (officer’s report in possession of the author and The
BMJ).
We can infer that there was dissent with respect to Desai’s appointment from at least some of the national medical associations that make up the WMA, because Desai accused a “western lobby” among the associations of racism for opposing his appointment, a claim that was challenged three dayslater.16 17
However, we do not know exactly what representations these associations made, because the proceedings of the WMA are secret, and any dissent was evidently ineffective in preventing the appointment.
At the very least, his appointment shows poor judgment by the WMA. Desai’s presidency should be suspended while an independent and transparent investigation is conducted into the decision making process that led to his appointment. This matter should be top of the agenda at the WMA’s 206th council session in Zambia this week.
With evidence of such flawed decision making, serious questions must be asked about the governance of the WMA—particularly how effective the WMA council is at scrutinising the actions of the secretariat. The Desai case alone would be worrying enough, but these are not isolated concerns. Recent letters to The BMJ from Derek Summerfield allege that the WMA has failed to respond appropriately to concerns raised about the Israeli Medical Association allegedly shielding physicians said to be complicit in the torture of prisoners in Israel.18 19
We might hope that a full and independent investigation would result in substantial organisational changes within the WMA.

daveberger@gmail.com

For personal use only: See rights and reprints http://www.bmj.com/permissions Subscribe: http://www.bmj.com/subscribe
BMJ 2017;357:j1955 doi: 10.1136/bmj.j1955 Page 1 of 2
Editorials
EDITORIALS


This above Article simply points to a larger continuing malaise, as explained in my blogs.

http://ddatta16.blogspot.in/2017/05/medical-council-of-india-mcis.html?m=1

Thursday 20 April 2017

Unfortunately​ Gian Sagar Medical College is facing closure

A death knell has sounded for Gian Sagar Medical College with the doors of most rooms, including classrooms, locked, power or water supply struck off, the only human sounds reverberating in the college corridors being those of protesting students and staffers. The faculty and staff have not received their salaries​ since October last year.

Read more at

http://education.medicaldialogues.in/chandigarh-gian-dagar-medical-college-closes/


Friday 14 April 2017

When patients strike a doctor, and doctors go on strike... Article by IMA President

This mail was in response to Dr. K. K. Aggarwal's (IMA President) Article on assaults on Doctors. 

Respected Sir,

Excellent article. The final lines on Medical Colleges is what junior entry level Faculty like me have been harping for years. Cleaning up the mess that is the Indian Medical Education Business is the need of the hour. Ensuring Uniformity in all ground level inequalities of Indian Medical Faculty Pay Scales and Service Conditions is the only way to ensure a certain standard of Indian Medical Education. Behavioral changes in Faculty mindset is the only way to transmit the same to the Students too. Such transfer of positive behavorial and ethical attitudes are only possible when a Faculty is herself/ himself in a positive frame of mind and not when victimized, harassed and kept on leash. I again share the link of some very important changes needed in Indian Medical Education to improve its Standards. I hope IMA looks at the communications in a positive manner.


1. SOCA petition to MCI - to revert Faculty Numbers by not LOWERING THE BAR further on MINIMUM Standard Requirements (MSR) to run a Medical College.




2. Suggestions to Honbl SC mandated OC - on how the created perception of 'ARTIFICIAL SHORTAGE' of FACULTY' be addressed.





3. Post on OFAMOS - on how Faculty Constitutional safeguards are violated.



Regards

Dr D Datta
MD (Anatomy)

#IndianMedicalFaculty practising HIPPOCRATES' OATH not HYPOCRITES'

Twitter @ddatta16


(Opinions are mine, not my employers)

The Article is pasted below

BY INVITATION

When patients strike a doctor, and doctors go on strike...

KK AGGARWAL
COMMENTS   ·   PRINT   ·   T+  
  • Doctors at risk Resident doctors protesting in Mumbai vivek bendre
    vivek bendreDoctors at risk Resident doctors protesting in Mumbai vivek bendre
  • KK AGGARWAL
    KK AGGARWAL
The doctor-patient relationship has changed over time, and needs new guidelines
Of late, cases of violence against medical establishments by aggrieved patient families are on the rise. Most of these are in emergency departments and on doctors and medical staff on duty. And quite often, they end in the medical staff going on strike, protesting the violence.
While the Indian Medical Association (IMA) supports a doctor’s right to protest, it should not be at the cost of patients. Under no circumstance should emergency services be disrupted. But the IMA also feels that the administration and the government should be taken to task for allowing the situation to get out of hand.
In a recent survey, the IMA found that over 75 per cent of doctors had faced mental or physical violence at least once. In another recent survey of 1,246 patients, the IMA found that 70.4 per cent of them expect their doctors to tell their patients about themselves, 90.1 per cent want doctors to listen to them in great detail during the first consultation, 80.4 per cent want the doctor to explain in detail about the drugs, investigations and the treatment, and 39.4 per cent expect the doctor, too, to say ‘thank you’ to them.
These expectations from the patients are impossible to meet, given the doctors’ workload. Most resident doctors work more than the allotted hours, often for 36 hours at a stretch. India today needs twice as many doctors as are available, three times as many nurses and four times as many paramedics.
Besides, there has been a paradigm shift in the expectations of patients too. Earlier, patients had full faith in their doctor; today, they want to be involved in every medical decision made. Gone are the days when doctors used to take decisions by assessing the risk on behalf of the patients.
There was a time when doctors were treated as gods. Doctors are expected to maintain their cool at every stage, even when patients and their relatives are in acute distress or in emergency situations. Even if patients misbehave, or give way to road-rage type of violence, doctors are expected to treat them calmly, and not react to the provocations.
The Supreme Court has ruled that in emergency situations, any mistake committed by a doctor may not amount to negligence.
In any case, there is little or no justification for the public to take the law into their own hands.
The protection provided by the state to doctors needs to be strictly implemented and a Central law to enforce this should be enacted at the earliest.
In any case, medical establishments need to deploy security at their clinics and hospitals. They are high-risk zones as they are likely to encounter drug addicts, substance abusers, injured criminals running away from the police, cases of murder, rapes, child sexual abuse and so on.
One of the quick-fix solutions is to deploy CCTV camaeras mandatorily in all emergency areas and record all conversation between doctors and relatives in high-risk medical areas.
Recently, the Medical Council of India had suggested that there must be video recordings of all consent secured from patients or their relatives for the conduct of medical procedures.
Medical colleges also need to redefine their teaching in MBBS. The focus needs to be on knowledge, skill and behaviour. The lessons need to incorporate modules on humanitarian conduct, including etiquette and ethics. Sadly, however, the current focus is only on acquisition of skills and knowledge.
×
The writer is National President, Indian Medical Association and Heart Care Foundation of India, and is a Padma Shri Awardee. Views expressed are personal.
(This article was published on April 14, 2017)

Monday 3 April 2017

Indian Medical Association (IMA) role

Let me start with the latest, a reply from a President of IMA to one of my tweets; please note the disconnect and dichotomy in the reply.

https://twitter.com/docraviw/status/1183081438029041664?s=19

The Indian Medical Association (IMA), of which I too am a life member, has no idea that the PROFESSIONALLY qualified Indian Medical Faculty are also DOCTORS. IMA role seems to be limited to the PRACTITIONERS side of things. After all isn't this the MONEY END of the Noble Profession with conducting CMEs and Conferences, as part of MARKETING, being the most important activity. Of course the food served is great, courtesy, sponsored by some fellow selling Gelusil.

I paste below a mail to IMA President (Elect at that time) dated 15/11/2016.

---------- Forwarded message ----------
From: Dyutimoy Datta <ddatta16@gmail.com>
Respected Sir,

The World Medical Association (WMA) is headed by Dr. Ketan Desai. This gentleman is famous for all the wrong reasons. And he got a clean chit from Central Bureau of Investigation (CBI), which as every Indian knows, functions by responding to certain Masters' Voices and instructions; seriously CBI clean chit can never be a gold standard of absolving anybody. The whole system survives on 'You cover my back, I cover Yours'. And it is a well known fact in many circles, including Private Medical College owners circles, as to which Politician covers Ketan Desai's back. And probably because this cover can no longer pretend to be continued, given Honbl. PM Modi's mission of cleaning corruption in all spheres, Ketan Desai had to look to foreign shores to carry on his image. So an endorsement from exported corruption is really not as impressive as you make it appear in your mail. Similarly, you are also known as a follower and endorser of Ketan Desai, during his operational heydays in Indian Private Medical Colleges mushrooming business. It appears that you are trying to improve his image by all these advertisements of his post. You are also known for your family ties to an Attorney General of India, and are utilizing such proximity to direct policy, unilaterally, in favor of such cohorts and certain nexuses. 
Why should an ordinary Indian Medical Faculty like me feel that you are not what you appear to be? It is because, I, as a life member of Indian Medical Association (IMA), Puducherry Branch, did not know of your planned Satyagraha on 16/11/2016, that is tomorrow, until today evening, when you mailed the same to a forum 'Medical Voice for Policy Change'. You, yourself added me as a member of this forum a couple of weeks back. Since then, the only thing you were mailing was about the quality of air in New Delhi. And out of the blue you send a mail about tomorrow's Satyagraha. What you have written in your open letter to Honbl. PM contains your own point of view, you did not bother to take the views of the entire community of IMA members and Indian Doctors. I, personally, have sent you many mails on the plight of Indian Medical Faculty, with regards to non uniform pay and service conditions. I have personally sent you mails of instances of corruption in MCI inspections. You have never bothered to reply. Your open letter to Honbl. PM does not contain a single mention of Indian Medical Faculty. Does it mean that only Doctors who practice and deal with patients, are the real Doctors, and Indian Medical Faculty do not belong to the category of Doctors. You are simply hijacking the issue and blaming National Medical Commission (NMC) bill's provisions related to selection of members, as opposed to election of Members as per Medical Council of India (MCI) act. See how openly it shows that you and your group of similar minded people are more interested in holding various offices and posts; you simply have no genuine concern for the problems of other Doctors. IMA has never really helped any Doctor when problems are genuine. You cannot even file a proper case with proper homework and preparation despite your familial ties with an AG of India; IMA lost its case for abolishing of PCPNDT Act. And you want to lead Doctors on a Satyagraha for abolishing PCPNDT Act. Please stop diverting issues. You are trying to direct away public opinion from MCI's abject failure in protecting interests of Indian Doctors, to procedural affairs of NMC. Instead, if you are a genuine person and with the interests of Indian Doctors at heart, as President of IMA you should have welcomed NMC for trying to break the autonomous dictatorial grip of a closely knit crony group of nepotistic officials who were only feeding themselves at the expense of Indian Medical Education standards. You should have opposed the shifting of the MCI team, including its President, to the National Board of Examinations (NBE); they were a tainted group and they simply got shunted to other cushier chairs. You should have conducted a Satyagraha against Agents- Ghost Faculties- College Managements- Higher Officials- Politicians nexus that has been the bane of Indian Medical Education for over a decade. The very fact, that you have not addressed such ground realities, shows how deep runs the need to have 'Birds of the same feather flocking together'. You should have offered genuine suggestions incorporating steps to alleviate genuine ground level problems affecting Indian Medical Education. I am sorry that the affairs of Indian Medical Education and related Healthcare businesses are in such shambles because of being repeatedly led by self serving individuals and groups. And your planned Satyagraha is a contempt of Honbl. Supreme Court (SC) , you are questioning the wisdom of SC appointed committee. If you are a genuine person, approach the Honbl. SC with genuine interests of Indian Doctors after proper preparation of case notes. You have the means and connections for the same. Or conduct a genuine Satyagraha to alleviate ground level existential issues and not for issues that deal with grabbing a chair or earning more money through business. Please do not question newer policy changes of Union Government, try and add genuine suggestions to it. Hence please do not waste your acumen in perpetuating the same evils that have plagued Indian Medical Education, for more than a decade. Use your wisdom and not your ego and greed. If I am wrong, reply to me in such an open manner, explaining what you are genuinely doing for Indian Doctors, instead of such acts of posturing to gain mileage for some new post you must be eyeing for the future. God save Indian Doctors from hypocrites at the top.  

Regards
Dr D Datta
M D (Anatomy)

The proposed NMC as an alternate response to MCI CORRUPTION, is being currently examined on its capability to replace MCI, by a Group of Ministers (GoM) led by Shri. Arun Jaitley, Union Finance Minister. It will not be a surprise if NMC gets axed in favour of continuing MCI, or a toothless NMC is foisted on the nation; Ketan Desai's stakes are high, his MCI and Indian Medical Association (IMA) team members' stakes are high. Stakes are high since a substantial amount gets voluntarily donated by the team, for over a decade, to fund Indian Elections. Imagine the amount of time and money, down the drain, for simply studying the feasibility, or lack of it, of a National Medical Commission (NMC) to replace Medical Council of India (MCI).

See one small recent example of the undercurrent of whose role is more important in gathering the juicy portions of the kill between MCI and the rest led by NITI Aayog/ OC/ NMC or whoever or whatever be the label.


Thus the fight goes on, for juicier titbits, between MCI and the Rest, namely, the Board of Governors during the 2010 fiasco of Ketan Desai's arrest and continuing through the Oversight Committee (OC) mandated by Honbl Supreme Court to oversee MCI functioning to NITI Aayog recommended NMC.

As recently as August 2017, Dr. K Aggarwal, the IMA President, continues to endorse, use and preach Dr. Ketan Desai's name. See this advertisement in Indian Express. I mailed Dr K K Aggarwal to stop such use of a tainted person till Authorities proceed and complete the cases pending against him in different Courts of Law.



The opposition is to any meaningful reforms in Indian Medical Education. Please see the actual reforms needed, but obstructed by such vested interests.

http://ddatta16.blogspot.in/2017/03/suggestions-sent-to-honbl-sc-mandated.html?m=1

The newly proposed Indian Medical Services (IMS) on the lines of Indian Administrative Services (IAS) should never contain a single member of Ketan Desai and his Cabal, especially Dr. K K Aggarwal, who have converted Indian Medical Education into a Family Business. This is because of the relationship between the Attorney General (AG) of India and Indian Medical Association (IMA) President and thus by extension, to the great Ketan Desai.

http://www.pbtindia.com/archives/2884


Dr. K. K. Aggarwal and the IMA, under other such eminent past presidents, were spectators and neither represented nor tried to address Faculty issues vis-a-vis MCI Assessments and related Irregularities and never attempted to correct faulty MCI policies, thus encouraging such gross irregularities.

http://ddatta16.blogspot.in/2017/05/medical-council-of-india-mcis.html?m=1



Please see how this CABAL operates at the link below.

http://ddatta16.blogspot.in/2017/03/polity-vs-bureaucracy-ruined-and.html?m=1

On 15 nov. 2016, at 17:04, Dr K K Aggarwal <hsgima@gmail.com> wrote:

Indian Doctors' Protest Supported by WMA

(15.11.2016) A peaceful demonstration by thousands of Indian doctors tomorrow (Wednesday) over the Indian Government’s move to undermine the self-governance of the medical profession has been supported by the World Medical Association.
The Indian Medical Association is mounting a major nationwide campaign in protest at moves to scrap the Medical Council of India. The present Council has 130 members, having a representative character with two thirds elected and one third nominated professional members representing the entire spectrum of professional stake holders. The new body, the National Medical Commission, would have 19 handpicked members nominated by the Government of India. It will be a 100 per cent nominated Commission with no representative character, mostly comprising non-doctors without any autonomy.
Thousands of physicians in every state across India are expected to take part in a two-hour peaceful demonstration to urge the Government to think again about the reforms.
Dr. Ardis Hoven, Chair of the WMA, said: ‘The autonomy of the medical profession is under threat throughout the world and what is happening in India is happening or likely to happen elsewhere. Physicians everywhere have to speak out against the marginalisation of the medical profession and in support of professional autonomy which is essential for the good of high quality patient care.
‘The new Commission proposed by the Indian Government effectively means that non-doctors handpicked by the government will be regulating the medical profession without any autonomy. That is unacceptable’.
Tomorrow’s nationwide action by Indian doctors is also a protest at continuing violence against physicians and the criminalisation of medical errors.



Numerous communications to Dr K K Aggarwal to help Indian Medical Faculty from Exploitation and Subjugation, thus helping clean up the ROT in Indian Medical Education translating to improving Indian Healthcare Standards, have fallen on deaf ears.