#Medical-Consumer-Protection-Act: Pros & Cons: Advantages & disadvantages


As in last few decades, patients are defined as  consumers and Medical Consumer Protection Act takes roots, the whole system of medicine and healthcare has changed. All the new changes in regulation, insurance and legal system have resulted in facilitating and exercising an easy control of medical industry over health care, each revision has affected doctors adversely. They have been reduced to just only one small component of the industry, who deliver care and remain at receiving end for poor outcomes. Other important stake holders are patients. How this change has been beneficial for patients?   

     Suppressed professionals can be used to work more, get less paid and can be dragged to courts easily. It should be a win-win situation for all, except doctors. Therefore everyone makes merry, while doctors sulk, except those who can mingle with the present scenario,  act smart and are able to entrench themselves in  changed business and legal milieu.

Disadvantages of medical consumer Protection Act (Negatives, cons)

1 .Promotes Defensive medicine: Every patient with any illness has a potential for  complications. Progression of any disease state can cause death.  If doctors start looking at every patient as a potential litigant, especially while dealing with very sick ones, practice of defensive medicine is a natural consequence. This may manifest as excessive investigations, more use of drugs, antibiotics and even reluctance or refusal to treat very sick patients. Worst scenario of excessive fear will be refusal of very sick patients in emergency situations or non-availability of doctors.

2. Erosion of doctor-patient relationship: Stray and occasional Incidents about negligence, the cases in courts or their outcome attract wide publicity in media. People are unable to understand the correct application of such stray incidents to themselves. But they always try to imagine themselves being in the chaos or scenario projected. Because of prejudiced notions, a sense of mistrust gradually creeps in, which then extends into   and involves their own  imagination and  circumstances. This sense of mistrust multiplies manifold whenever there is some adverse or even small unpleasant event. Ultimately doctor and patients move forward together with a strained relationship and the treatment goes on with a surmounting sense of mistrust.

 3. Increased cost of care:   With the increasing need for defensive medicine, there is a need to document everything and to offer everything possible in the world, leading to increased  medical costs.  Insurance companies, medical industry and lawyers have positioned themselves in between doctor and patients. They charge everyone on both sides, heavily for allaying the fears, both  patients (medical insurance, lawyer fee) and doctors(indemnity insurance, lawyer’s fee) alike. The vicious cycle of rising costs, need for insurance, medicolegal suits, and high lawyer fee (for patients and doctors) goes on unabated. All these contribute significantly to overall increased cost of health care.

             25 factors for rising cost and expensive medical care.

4. Enhanced insecurity in medical profession: Needless to say, consumer protection act has increased the anxiety and insecurity of  the medical profession. One keeps wondering which patient will prove to be his bane and finish his total career, will result in professional hanging or a media trial. There is a real probability of being entangled in these problems in present era in day to day practice.

              Disadvantages  of being a doctor, nurse

5. Unnecessary litigation: Legal cases can be put on doctors for various trivial reasons,  for example the sense of revenge or to extract money or simply for avoiding  to pay for services.  In an era where family members, brothers and sisters fight for money, it will be naïve to think that idea of making money from doctor does not exist. These ideas  are further stoked by the incidents of previous high compensations granted  by courts .

   

6. Increased paper workexcessive documentation and time consumption: crucial and large chunk of time of doctors and nurses,   goes in completing documentation. Needless to say, this time previously was dedicated solely to patient service. Management is now-a day more worried about completing paper work as well. Initially it was a symbolic documentation, but now there is requirement of mammoth paper work. It leads to consumption of time that was meant for real discussions for the benefit of patients.

7. Doctors used as scape-goats for revenge: Any unsatisfied patient can vent his anger by putting complaint or case against the doctor.  This is done to some extent for revenge or just finding a human factor which can be punished. Not uncommonly doctors are used as scape- goats to have a concession on the patient treatment by administrators. Everything can be easily put on doctors as they are universal final link to a patient’s treatment and adverse effects.

8. Distraction of doctors from the primary point of intention:  Nothing else ever has distracted doctors more than  medico-legal cases and punishments. In certain circumstances, saving themselves becomes more important than saving a patient. Uncertainty of prognosis, grave  emergencies, split second lifesaving and risky decisions that may later be proved wrong by retrospective analysis with wisdom of hindsight.   Complex  medico-legal situations are endless distractions that have creeped in and are enough to distract doctors from primary point of intentions ‘the treatment.

9. Early retirement or burn out:  Becoming a doctor and practising has become a tough job. After people have reached a point of financial security or when near point of burn out, doctors tend to leave practice. No wise man will like to face medicolegal complexities in older age. Taken to court for a genuine decision is enough to spoil and tarnish  health, wealth and fame that was  earned by  slogging  the doctor’s whole life.

10. Reluctance to do emergency, risky work: If the decision to decide or act or help someone in an emergency situation, puts one’s own life and career to risk, why should anyone put himself in that difficult  position?  Therefore increasingly, financially secure doctors are staying away from the riskier jobs.

11 .Only Doctors are sufferers of the act: Patient can have poor outcome because of any reason. It can be severe disease, poor prognosis, rare or genuine complications or even unintentional mistake or human errors, system errors or deficiency. But retrospectively doctors can easily be blamed because of wisdom of hindsight.  All patients, who are unsatisfied or with unrealistic or unexpected outcome can go to courts. Whatever court decides, harassment of doctors is full and permanent. There is no compensation possible for the sufferings and agony spanned over years, even if court decides in favour of doctor.

12. Spoils teamwork among doctors; Whenever there is adverse outcome in any patient, all the doctors involved may start looking  for,  whom to blame  among themselves. All of them will try to pinpoint each other’s mistake.  Such situation produces a bitter and worst kind of disagreements among various teams or specialties. Mutual understandings take a back seat and the teamwork is spoiled permanently. Administrators in a bid to be safe,  encourage putting doctor’s concerns against each other, creating a strange sense of enmity. Ultimately  a mutual understanding and team work takes a hit.

13. Doctors converted to cheap labour:

Hugely benefitted are medical industry, law industry and administrators; The ease with which doctors can be harassed  has lead to rampant misuse of consumer protection ac and t has instilled a sense of deep fear in mind of medical professionals. The act has been used as a whip against the  doctors by all these three stakeholders. Fear of medicolegal cases has reduced doctors to cheap labour. Industry has used the protective systems to gain the maximum out of doctors hard work.  Benefits to law industry and lawyers  are obvious and don’t need to be elaborated. Besides this, even insurance industry has collected money both from doctors and patients by creating the fear.

14. Confusion while treating; Right decisions ?  A certain element of doubt always remains in minds of doctor whether he will get justice in the long run, or will end up being victim of sympathy towards patient or clever lawyering.  What was medically right and judicious decision at that real time situation may be  looked as  wrong later, especially when retrospective analysis  is done over years with fault finding approach. So taking medical decisions is becoming more difficult amid future uncertainty of disease.

15. Delayed treatment in emergency situations: Due to prejudiced minds, it is not uncommon for patient’s relatives to keep seeking second opinion, thereby delaying consent for procedures, surgeries and treatment. Though doctors know this problem, but they obviously cannot proceed without necessary documentation. With increasing mistrust, even emergency treatments are delayed. Delay in surgeries or therapies are a common outcome.

16. Instigation by law industryWindfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession: One can see zero fee and fixed commission advertisements on television by lawyers in health systems even in developed countries. They lure and instigate patients to file law suits and promise them hefty reimbursements. There is no dearth of such relatives, lawyers who are ready to try their luck sometimes in vengeance and sometimes for lure of money received in compensations.  This encouragement and instigations of lawsuit against doctors is a major setback for medical profession.

17. Hostile environment for young impressionable doctors: The young and bright doctors complete their long arduous training and then suddenly find themselves starting the work in a hostile environment. They find it strange to find themselves  at the receiving end of public wrath, law and media for reasons, they can’t fathom. They work with  continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.

18. Doctors have become ‘Sitting ducks’  for  continuous blackmail: Even with routine complications amongst very sick patients, a threat looms over doctor’s head. People do not accept even the genuine complication, what to talk of unintentional mistakes.   Mistakes   are always easy to be  pinpointed with retrospective analysis and with lawyers pondering over it for years. In such situations, doctors are sitting ducks for  any kind of blackmail.

 19. Demoralization of medical professionals – as selectively applied: strangely it applies   only to doctors. All of other professions are   out of it. Selective application is what demoralizes doctors.  Considering the uncertainty and kind of work of medical profession, actually it should be other way around. 

The consequences are like victimization.

Advantages of Medical Consumer Protection Act: (Positives, Pros)

1.  Redressal of grievances:  patient will get satisfaction, if there is a genuine negligence case

2.  Better quality of care ;  medical systems will improve as they will need to lessens the errors and  court cases. Better systems from abroad are also copied to improve the efficiency.

3. Better introspection by medical profession: although doctors from the beginning are sensitive about their work and always look at how better results can be achieved. But act will make this process more formal and official.

4. Training of medical professionals: it will be difficult to put errors under carpet.  Doctor will like to get trained better as no one want to be in soup.

5. Future  learning from court cases:  each and every court decisions  is viewed carefully by medical fraternity. Improvement in protocol and policy making is a natural consequence.

6.  Eye openers for medical profession: court cases and decisions have acted as eye opener for medical profession. It gives an idea, how law looks at medical treatment. It has made clear that medical science and medical law are a bit different. In real time, things are easier to be said than done.

 7. Better documentation and communication: for doctors to save themselves, documentation is the key. Previously doctors were doing everything, but not documenting much. But now there is lot of stress on documentation.

   Stress itself is not a bad thing. It can often help us perform at our best, expand beyond our limits and  achieve  better results.   The real problem lies in the fact that in this age,  anxiety prevailing more for care givers, a sense of injustice prevails . Stress generated can alter the ways, the patients get treated.  If the core of the health care  (medical hands) are harmed, no one can benefit in the long run.

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Reel Heroes vs Real Heroes

TRUMP BLAMES DOCTORS FOR COVID


Unparalleled sacrifice by medical community during pandemic  has not  resulted in any enhancement of  respect or prestige to the medical  profession. It was not enough  to stop physical or verbal assaults, legal or financial  exploitation. It was sufficient  to alter the course of oppression  by administrators or moral blackmail by society.

    Sadly it is getting more worse. Doctors and nurse have been reduced to sacrificial lambs, that are easily slayed, when administrators tend  to put  themselves on high moral  pedestals.

      Financial and legal complexities have been the major side effects of modern medicine, especially for doctors. They are facing  complex  environment,  which are beyond their control. Besides financial and legal complexities, moral dilemmas, facing verbal and physical assaults are creating  complex working conditions. Criticized  by administrators despite their sacrifice, media insults are adding to their disillusionment and possibly  a withdrawal response.

    Arm chair preachers would just say “yes, as a doctor, they should do it as moral duty.”

         Media and celebrities usually   have proudly   projected on screen and television that it is right to be disrespectful towards doctors. They have made it appear correct to masses  to be disrespectful to doctors. But such  news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession.

     As incidents are widely publicized and masses following their “Reel Heroes” and celebrities  to insult medical profession.

    Disrespect and media insult by celebrities towards a profession as a normal  routine  and perceived as an   easily do-able  adventure  to gather populism.

On the night of October 24th, President Trump addressed his supporters at a Wisconsin rally, located just minutes from a temporary COVID-19 field hospital, making the argument that doctors at the pandemic’s front lines are falsely capturing COVID-19 cases in order to profit from the pandemic. Undermining his own scientific experts was not enough to dispute the severity of the crisis. Now, he desperately suggests — “I don’t know, some people say…” — that America’s most trusted professionals are fabricating the rising coronavirus case numbers of the current “third spike” for personal financial gain.  

Trump’s wrong insinuations

As doctors we are outraged by Trump’s gutless insinuations. We’re not alone. The American Medical Association, American College of Physicians, and the Council of Medical Specialty Societies, leveraging the voices of over 800,000 American physicians, have each castigated Trump for his callous allegations.

The mere implication that health care professionals would be incentivized by profit to alter the true rate of this public health pandemic is reprehensible. Here’s why:

We struggle to contain the losses — and we continue to lose our own. For months, we have worked tirelessly to contain the spread of COVID-19. As we approach a quarter of a million deaths nationwide, we cannot forget the 1,700 of our own health care colleagues among that number. We are the teams that care for everyone, day and night, as we risk our own lives for the benefit of our communities. Unsurprisingly, we are burnt out. These last seven months have been a marathon in resilience, frustration, and fear. 

Here’s the truth: We label patients with COVID-19 because accurate identification of this disease is essential so we can track cases to take the quick action necessary to prevent further spread. If a patient has a history of heart disease or other medical problems, and dies in the hospital with COVID-19, we know that coronavirus exacerbated that underlying condition — and their demise. It is accurate and in line with public health principles to list it as a cause of death.

We face historic furloughs, layoffs and pay cuts. 

Here’s what’s worse: the assertions that doctors are profiting off of the pandemic are completely baseless and could not be further from the truth. Physician practices are not immune to the economic losses Americans are experiencing. One in five American physicians, whether salaried or in independent practice, have experienced pay cuts during the pandemic. Hospitals and physician practices have had to implement furloughs and layoffs to stay afloat, including furloughs at 35% of all primary care offices. More than 16,000 — or 9% — of independent physician practices have had to close entirely. 

More recent estimates suggest that hospitals, thanks to the loss of elective surgeries during pandemic spikes, will face over $300 billion in lost revenue this year alone. And this is all happening while physicians report working more hours this year — amid more uncertainty about the future of their profession.

Doctor: My Sept. 11 fear of flying made a comeback with COVID-19. Was I wrong to worry?

We still work in unsafe conditions, without the equipment needed to protect us — and you. In the spring, the images were indelible: N95 masks being reused for days on end, while nurses were covered in trash bags as a proxy for PPE. Across the country, hospitals, clinics and state agencies bid against each other for what few PPE supplies existed. All the while, President Trump accused health care workers of hoarding PPE and other medical equipment. He blamed health care workers for shortages across the nation, when the root cause of that unfolding tragedy was his administration’s unwillingness to enact a national and comprehensive strategy.

Fast forward to today, where many healthcare workers still do not have adequate PPE and continue to reuse masks, gowns and gloves meant for one-time use. This could have been easily addressed by now, had President Trump fully activated the Defense Production Act to speed up and nationalize PPE production, a request he consistently refused. 

The long road of COVID ahead

We see no end in sight. White House Chief of Staff Mark Meadows made it clear: the Trump administration has given up trying to control this pandemic. While they wave the white flag in hopes of therapeutics and vaccines becoming available in sufficient quantities for all Americans, hundreds of thousands more are projected to die. 

COVID immunity:COVID-19 herd immunity strategy fits Donald Trump’s failures in coronavirus war

The new “medical swamp” narrative emerging from the White House, while deeply disturbing, is not out of character for this administration. Since the first U.S. coronavirus case was reported in January 2020, the president has undermined his own health experts and denied the scientific evidence at every turn. 

The coming weeks and months will be dark as we continue to experience the repercussions of Trump’s callous inaction, but you have the ability to shape how this story ends. We urge all Americans to elect leadership that is morally responsible, unwilling to allow the political manipulation of science. The lives of the American people depend on it.

advantages disadvantages of medical profession

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Covid-Warriors or Beggars: Doctors without pay


    Imagine a highly skilled professional community, which can be harassed, assaulted, dragged to courts and subjected to cruelty beyond imagination. Ironically, the despise to this community  comes from the  very people, whom they are trying to save.      

     Even the rightful is denied in a shameless manner, as if their lives don’t matter. During pandemic, doctor and nurses treated as dispensable disposables. A mere lip service to call them Covid-warriors  was performed, but real treatment  to these selfless health workers was akin to sacrificial lambs. 

    The plight of doctors of Hindu Rao Hospital is just an indication of the real thought process and apathy of administrators. If doctors are forced to beg for  basic fundamental rights, their situation is worse than beggars. The current unfortunate situation is enough to  convey  a message to the medical profession, the nation and is  demoralizing the entire doctor community, more so to the aspiring doctors.

Doctors at Hindu Rao Hospital unpaid for months

    Irked over non-payment of salaries, doctors and staff members of North Delhi Municipal Corporation’s Hindu Rao Hospital have decided to sit on indefinite agitation from Monday onwards. The emergency services will, however, operate smoothly.

The doctors and staff members of the hospitals have not been paid since June. Last week, the staffers were on a ‘Pen Down Strike’ from 9 a.m. to 12 p.m. to display their ordeal. According to the civic body, the matter is being looked into.

The letter written by the Resident Doctor Association to the hospital administration stated, “We apologise to announce that we are forced to go for an indefinite agitation w.e.f. October 5, 2020 considering strictly ‘No pay, No work’, while operating the emergency services smoothly.”

It added, “The chronic sufferings of the staff have been too agonizing and intractable where it is distressing to one’s mental and physical well-being, We strongly plea to you for releasing 3 months’ pay and giving us an immediate permanent solution. We also demand a formal notice regarding the same.”

The association rued that despite the High Court Order and repetitive intimations in the past, the salaries of North MCD doctors and staff are long overdue for three months and its ongoing four months.

Besides Hindu Rao hospital, doctors and nurses of other hospitals like Maharishi Valmiki Infectious Diseases, Kasturba Hospital, Girdhari Lal Maternity Hospital and Rajan Babu Institute of Pulmonary Medicine and Tuberculosis have also been protesting over non-payment of dues.

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#NEET: Paying Irrational Fee for Medical College Seat: An Unwise Idea


At a time when medical students and even doctors are uncertain whether opting for medical college along with the vulnerability and risk associated with   becoming a doctor is worth it or not, some are naive enough to pay millions as fee for medical education and for securing a seat of MBBS.

     A famous axiom “as you sow so shall you reap” has an application to health system. One is convinced that industry selling medical college seats has been quite powerful and practically, every technique to sell seats is prevalent to bypass the merit and deny seat to deserving candidates. These meritorious children, who are denied seats could have been   good doctors and   real custodian for the health of people.  But if for some reason, business prevails and government fails to prevent this cruel and corrupt selling of medical seats, an Einstein brain is not required to guess the whole malaise prevalent in health system

         Truth cannot remain hidden for long.  It has to be realized that getting into medical college is a minuscule component of the process of becoming a good doctor.  Once they opt for this profession, the real tough and prolonged battle begins. Quite a few successful candidates may eventually feel that the money spent and the hard work may not be worth it, especially those who may have invested in heavy fees and in debt.

   Although the whole effort and huge expenditure to become doctors in this way may be really worthless in today’s scenario, considering the difficult times and vulnerability of medical profession

Paying the irrational fee of medical colleges may be an unwise idea for the candidates, who are not from strong financial backgrounds. But at the same time unfortunately, it may be a compulsion and entrapment for students, who have entered the profession and there is no way forward or fail to get residency.

The government should regulate these fees and also ensure that if a heavy fee is charged, then it should be spent on medical education of students only. It should not take a form of just any another money minting industry to be used for other purposes.

        Going by selection criteria  of candidates as doctors, if given a choice, by whom a patient will like to get treated? A candidate who scored 20% – 30 % marks or a person getting 60% or 80% marks. NEET eligibility getting lower and  candidates getting around 30 % of marks  may be able to secure a degree to treat patients.  What will be the deciding factor? So in the end, seats remain unfilled and may be a kind of auction, whosoever can pay millions, takes the seat.

    Ironically, that strange equation is acceptable in lieu of money paid!

It is ironical that the medical profession is regulated, but medical business or medical education is not.  Such business of producing doctors based on their paying capacity should be clearly trounced for the benefit of public. Foundations of healthcare should be on touchstone of merit, ethics and character and not based on business deals.

       Therefore meritorious students, especially from average backgrounds, who opt to become doctors feel cheated when they pay massive fee to buy a seat. It is an insult to the very virtue of merit which should have been the sole criteria for these admissions.

     It is the people and society, who will be the real sufferers in future. Therefore resentment to such system should come from the society.  If the society continues to accept such below par practices, it has to introspect, whether it actually deserves to get good doctors.

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Dr Deben Dutta Mob Lynching & Murder: Lesson for Doctors


Dr Deben Dutta   lynching and murder by mob in Assam last year, was a new low in the current era of deteriorating doctor- patient relationship. In the era, where consumerism was imposed on doctors in most crude form, media and law industry taking advantage of the situation for their benefit.  Complexity of medical science has taken a back seat. The consequences and the brunt of resultant negativism were borne by doctors. Dr Deben Dutta was victim of venomous negativism spread by media against doctors in general.

     Every incidence of verbal, legal, and physical assault is a trust breaker. It is not only erosion of patient’s trust on doctors but the vice versa is also true.  As a rule of nature, as violence increases, compassion decreases. Patients might get their revenge for one stray incident, but they will lose compassion and trust of doctors in the long run. Millions of lives saved everyday by medical professionals were of no consequence.

   GUWAHATI: An Assam court on Tuesday awarded death sentence to a tea garden worker and life imprisonment to 24 others in connection with last year’s lynching of a 73-year-old doctor. Dr. Deben Dutta, a senior medical officer of the Teok Tea Estate hospital in Jorhat district, was lynched by a mob on August 31 last year for his alleged delay in treating a worker, Somra Majhi. Dutta was attacked with sharp weapons and he succumbed to his injuries on the way to a hospital. He had served at the tea garden for over four decades. His killing had triggered widespread outrage.

   The impunity   with which attendant easily and brutally assault doctors is really appalling.  Should  such incidents  be shameful to law enforcing agencies? Are we a lawless society? More problematic is the government apathy and silence of bodies like human right commission.

          In this case, at least the culprits have been brought to book and punished by the court. But still the root cause for such gruesome incident is not addressed. The danger for the medical fraternity is still lurking due to many factors. Risk to the doctor not only comes from the infectious diseases, but can be there because of physical and legal assaults. It can be just consequent  to  venting out  emotions of angry relatives, resulting from a  natural  poor prognosis, but blaming the doctor. Doctors who are universal common link present at the time of death of patients, become victims and punching bag.

       There are lessons to be learnt by doctors from such episodes. As patients are turning into   consumers, health providers cannot remain simply doctors as before. They need to develop skills to anticipate danger and save themselves.  They need to assess their place of work for their own and their family’s safety.

      Aspiring doctors should choose this profession carefully and take a well informed decision.  Such incidents are warning signs for the young generation, who are oblivious   and ignorant to the risks faced by doctors in present era.

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Admin Apathy- Kerala Doctors to Protest State’s ‘lack of concern’


         Doctors and nurses are now  getting out of their own self-imposed moral enslavement. Rather they are now forced to do so, as their lives and deteriorating working environment are becoming impossible to be in. One cannot burn himself in a furnace for eternity, for the well-being of others, especially if others are not concerned.

      The incidents at few places are just a tip of the iceberg. Covid has helped doctors to bring forth their plight. Doctors and nurses not paid for months in some Delhi Hospitals.  Doctors openly ridiculed and scolded by Administrators for no fault of theirs. Even a doctor lynched by mob in Assam and many assaulted at other places. Hospitals vandalized indicate that there is danger lurking for doctors everywhere. Most sad part is that, there are no firm administrative hands to deal with the menace.

     Clearly Well being of doctors and nurses is not being taken care of. They are being used as dispensable disposables. Such system, which is based on exploitation of the health workers, is becoming fast unsustainable. If apathy towards their genuine problems continues, negative attitude towards doctor and nurses persists,  it will kill the empathy towards patients as well.

 Overall, a complex scenario for doctors: There is increasing discontentment amongst doctors because of this complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients.  They are also supposed to maintain meticulous documentation and also supposed to work under norms of  medical industry. They are supposed to see large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult. Additionally there may be bullying by certain administrative systems at places, who use pressure tactics to get their own way.

Government doctors in Kerala to boycott additional duties

    The Kerala Government Medical Officers’ Association (KGMOA) has declared that government doctors will stay away from all additional duties from Thursday, in protest against the government’s apparent lack of concern about the plight of health-care workers who are overworked and fatigued, fighting on the front lines for the past nine months.

  The KGMOA has, however, made it clear that while declaring non-cooperation, COVID-19 care and disease containment activities will not be disrupted.

In a statement issued here, the KGMOA said that apart from ignoring the KGMOA’s repeated demand for deploying additional human resources in COVID-19 care activities, the government’s decision to take away the leave given to health-care workers after continuous COVID-19 duty was something that defied all principles of fairness. This was totally unacceptable, the KGMOA said here.

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Penal Servitude for Doctors, Nurses- Administrators Delight


                         Life for health care professionals like  doctors and nurses is hard in present era, right from getting into medical college, passing the exams, gaining experience, work under new imposed legal environment, with  over-regulation and under the moral burden of over-expectations of society. The benefit of these difficult situation is reaped to the maximum by administrators and overpowering medical industry.

            Despite working amid of a national emergency in Covid-times, the meagre salaries of hundreds of doctor and nurses are not paid for months in Hindu Rao Hospital, Delhi

         Ironically where doctors are punished for small genuine mistakes or even poor prognosis during  medical treatment, the blunders of health  administrators are taken as trivial issues.  More ruthlessness, cunningness or cruelty towards health care workers is possibly becoming an appreciated quality of health administrators.  Why no punishment for the administrators for such blunders?

     Consequently, with no support from society, to whom they serve, doctor and nurses gradually are pushed to a penal servitude. If this is regarded as normal in present era, anyone would wonder, what does slavery constitute?

   No salaries  for doctors for four months

The doctors alleged negligence and apathy on part of the government and said that they were unable to run their basic errands and accomplish their daily routine due to non-payment of salaries.

  Irked over non-payment of salaries for over four months in a row, doctors at Delhi’s Hindu Rao Hospital announced that beginning Saturday, October 10, they would stop attending to patients including those suffering from Covid-19. Hindu Rao Hospital, the largest municipal hospital in Delhi with 900 beds, is currently a dedicated Covid-19 facility.The doctors alleged negligence and apathy on part of the government and said that they were unable to run their basic errands and accomplish their daily routine due to being unpaid for months.Abhimanyu Sardana, President of the Resident Doctors’ Association (RDA) of the hospital, said that several letters and reminders had been sent to Delhi Chief Minister Arvind Kejriwal regarding the issue faced by the doctors, who are frontline warriors at the Covid-19 dedicated facility. “Don’t ignore the basic needs and rights of doctors,” wrote the RDA-Hindu Rao.

            Be it any circumstances like working without any facilities, poor infrastructure, non-availability of drugs, inhuman duties hours over 48-72 hours or poor pay, the administrators would say, “you are a doctor, it is your moral responsibility.”  Armchair preachers and administrators will always remind them of moral duties, but easily forget their own.

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Moral Dilemma: Should Doctors Stop Work-if unpaid?


         From the very beginning of medical career, certain phrases are repeated to doctors and become ingrained in their memory. Be it any circumstances like working without any facilities, poor infrastructure, non-availability of drugs, inhuman duties hours over 48-72 hours or poor pay, the administrators would say, “you are a doctor, it is your moral responsibility.”  Slowly doctors will adjust, keep on working and take hardship as part of their life. Armchair preachers and administrators will always remind them of moral duties, but easily forget their own.

        Humbled by the nature of profession and blunted  retaliation reflexes due to hard training and enormous studies, gradually they become moral slaves to themselves. Enlightened people will understand the situation as attaining higher  level of hierarchy.

      All the problems are taken as  part of “Routine Life of a Doctor.”   The long  Struggle to become a doctor, slogging in wards to learn and earn degrees, work in inhuman conditions, listen to endless abuses, tolerate the false media criticism, dragged in courts for alleged negligence, work with fear of physical assaults, work without proper infrastructure and manpower, endangering their own lives, exploited by medical  industry and administrators, poorly paid and  still not respected.   

          As doctors have not retaliated to deterioration, adapted  well to the slavery, situation is worsening. A  large hospital has not paid salaries to doctors for three months. Now  there is a moral dilemma for doctors: whether to continue work  or not?

Till society understands the concealed sense of enslavement that remains hidden, while performing these duties, the suffering of the profession will not end.  A problem that is clearly visible to every one,  but not admitted till now,  is in itself an evidence for a difficult scenario to be implemented. 

     Apart from moral dilemma, doctors will worry about legal implications. In present era,  amid maze of legal complexities, dilemmas are  unending. Among all such complexities, they have to worry about patients also.

    A strange situation, where thousands are being paid sitting at home,  The real warriors are unpaid.   Covid paradox: salary cut for doctors other paid at home

The resident doctors of Hindu Rao Hospital: indefinite strike from October 5 considering strictly ‘no pay no work’ 

NEW DELHI:  The resident doctors of Hindu Rao Hospital, the biggest medical facility under the North Delhi Municipal Corporation, will be staging an agitation against the administration due to their failure of paying the salaries of the healthcare workers over the past three months, said the president of the doctor’s body Abhimanyu Sardana.

The RDA of the hospital, which is also a dedicated Covid-19 facility, has decided to go on an indefinite strike from October 5 considering strictly ‘no pay no work’. However, essential services won’t be affected.


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Doctor' suicide or murder by media trial

        Aspiring doctors, especially those who spend millions and golden years of life to become doctors, should know the reality of present era. How cruel the society has become towards doctors.

      Struggling to become a doctor, slogging in wards to learn and earn degrees, work in inhuman conditions, listen to endless abuses, tolerate the false media criticism, dragged in courts for alleged negligence, work with fear of physical assaults, work without proper infrastructure and manpower, endangering their own lives, exploited by medical  industry and administrators, poorly paid and  still not respected.    Arm chair preachers would just say “yes, as a doctor, they should do it as moral duty.”

         Not only corona virus, but society may also drive doctors to death.

    The consequence and reverberations of the poor prognosis landed on the doctor, subsequent to the death of the patient.  Media and celebrities usually   have proudly   projected on screen and television that it is right to be disrespectful towards doctors. They have made it appear correct to masses that doctors  be beaten and assaulted, in case there are unexpected results or in case of dissatisfaction. But such  news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession. As incidents are widely publicized and masses following their “Reel Heroes” depicting violence against the doctor is seen as a routine and looked as an   easily do-able  adventure  due to  non-willingness of  authorities to take stringent action.

Kerala: Doctor ends life, medical fraternity blames ‘social media trial’

In a tragic incident, a young doctor from Kerala has died by suicide, reportedly after facing allegations of negligence following the death of a patient in his clinic.

Dr Anoop Krishnan, an Orthopedic Surgeon who used to run Anoop Ortho Care Hospital in Kollam was found hanging inside his house on Thursday. He had also cut his vein before hanging himself. The young medic had also inscribed the word ‘sorry’ with his blood inside the bathroom before he took the extreme step.

The 35-year-old was reportedly under stress for days after a 7-year-old girl who he had operated in his clinic died due to some complications.

The girl who also had a heart condition was admitted to Anoop Ortho Care Hospital for a surgery to fix a bent on her leg. Due to the girl’s heart condition, many others had reportedly declined to perform the surgical procedure.

Following the death of the patient, her relatives had filed a complaint against Dr. Anoop for negligence, alleging that an error in giving anesthesia caused the death. There were also protests outside the hospital by the relatives of the girl and an alleged smear campaign online against Dr. Anoop and his family. This, according to people who knew him had affected the young doctor who had made a reputation as one of the best orthopedic surgeons in the city.

Police said they are yet to ascertain whether the suicide was directly linked to the patient’s death.

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Story of Moral slaves: How Doctors bear full brunt #Covid


              Struggling to become a doctor, slogging in wards to learn and earn degrees, work in inhuman conditions, listen to endless abuses, tolerate the false media criticism, dragged in courts for alleged negligence, work with fear of physical assaults, work without proper infrastructure and manpower, endangering their own lives, exploited by medical  industry and administrators, poorly paid and  still not respected.    Arm chair preachers would just say “yes, as a doctor, they should do it as moral duty.”

             The Indian Express has been wise enough and has been able to  express the situation to some extent, which is just tip of the iceberg.

             Low pay and long hours, doctors battle more than just Covid-19.

 Maharashtra estimates it needs 19,752 doctors, nurses and paramedics to fight Covid-19. As on September 15, 12,574 of the posts were vacant. Dr Rajesh Salagare is the only doctor at Raigad rural hospital since March. (Express photo by Tabassum Barnagarwala) Chest physician Dr Pravin Dumne has just done his rounds of the ICU at Osmanabad Civil Hospital and is now fielding queries from anxious relatives. Two hours into the PPE, he is drenched in sweat, with 22 hours more to go in his shift. Dumne has 150 Covid-19 patients under him. Since May, he hasn’t been able to take any break except for 12 days when he himself contracted the virus. Norms mandate one doctor per 10 ICU patients, Dumne is handling five times that. “There are times when multiple patients are critical and I can’t be everywhere. I feel helpless. We are losing lives,” he adds. As another relative complains about the lack of cleanliness in a ward, Dumne says, “I may quit government service once the pandemic is over.” Dumne isn’t the only one feeling the unequal load as coronavirus cases surge in Maharashtra, particularly its rural areas. The state estimates it needs 19,752 doctors, nurses and paramedics to fight Covid-19. As on September 15, 12,574 of the posts were vacant. Of the 1,700 Class I doctor posts (including specialists) the Public Health Department needs to fill, like Dumne’s, only 538 are filled. In May, Maharashtra was forced to ask Kerala for help. Forty specialist doctors came to Mumbai on a bus, to handle critical patient load until July. The shortage is even more intense in rural areas, where urgent advertisements by the government for specialists have yielded little response. In rural Nagpur, as many as 93.6% posts are vacant, followed by Thane at 79%. The last permanent posting in Osmanabad, an aspirational district under NITI Aayog, was three years ago. It needs 150 nurses and 40 doctors. The state government has been deputing Ayush doctors to civil hospitals. “Not all of them can handle serious patients,” Dumne points out. He and Dr Tanaji Lakal are the only two specialist doctors for Covid patients at Osmanabad Civil Hospital. Dumne was moved here from the PHC at Samudrawani village, following the pandemic. Dumne and Lakal alternate working for 24 hours continuously followed by one day off. In July, when Dumne got the coronavirus, he had to join back within 12 days, instead of the minimum 14. The number game In Raigad, 400 km away, Dr Rajesh Salagare has been the only doctor handling the entire rural hospital since March. The three other doctor posts at the hospital have been vacant since 2018. The previous night he was called for a delivery at 2 am; this morning, he was back on OPD duty at 9. “I am just an Ayush doctor. If something goes wrong, I will be held responsible,” he worries. It’s not just the long hours that deter doctors from rural duty. A government MBBS doctor in rural areas is paid Rs 60,000 per month and is expected to be on call 24 hours, their counterparts in Navi Mumbai get Rs 1.25 lakh, and in Mumbai and Thane, Rs 80,000 per month. Navi Mumbai, Thane and Mumbai mandate eight hours on Covid duty at a time, apart from providing hotel accommodation. As a chest physician, Dumne could earn up to Rs 2 lakh in urban areas, instead of the Rs 60,000 he gets now. His August salary came only a few days ago. The 100-bed Covid facility in Ratnagiri depends on Ayush doctors from nearby PHCs. One such doctor, who requested anonymity, says he sees over hundred suspected cases a day. He got his pending salary of Rs 40,000 for four months, till July, only a few days ago. “Everyone calls us corona warriors, but look at how we are treated.” Dr Pravin Dumne (in white) at Osmanabad Civil Hospital. (Express Photo: Tabassum Barnagarwala) An administrative officer at Ratnagiri Civil hospital, who is waiting for his pay since July, shows text messages exchanged with seniors. “If the government doesn’t respect us, why will a doctor want to work here?” he says. Ratnagiri Civil Surgeon Dr Ashok Bolde says the delay in salaries is on the part of the National Health Mission’s state office. Dr Sadhana Tayade, Director of the Directorate of Health Services, however, says, “Salaries are paid on time to doctors.” On why the poor response to advertisements, she says it is because “doctors are scared to work in Covid wards”. The government has begun tele-ICU services to plug the gap of specialists in rural hospitals of Bhiwandi, Aurangabad, Jalna and Solapur. Physicians in another city monitor ICU readings of patients in rural hospitals and call up on-duty doctors to direct treatment protocol. But tele-ICU has not reached every rural hospital, nor can it help everyone.          Next younger generation of aspiring doctors, who is  witnessing to the cruelty shown towards health staff, may be forced to think about their decisions to become doctors.

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