Online Health Service Aggregators- New Commission Agents in Medical Business: Increase Cost


 

India features a mixed-market health system where chronically low investment in public health systems has led to the proliferation of private care providers.  In last few years, a bevy of apps and service aggregators have starting operating brazenly in the country, pushing aggressively for tests and surgeries and delivering drugs, often advertised by Superstars and Celebrities. Patient often zigzags between health providers with unclear referral pathways, and ends up receiving questionable quality of care that may typically neither be safe nor affordable.   

       Online health aggregators are nothing more than sophisticated commission agents. The medical business model thrives on advertisement and commission. Government rules prevent doctors from advertising or soliciting for surgeries, but these companies live on advertising. Any doctor or hospital can get advertised through these companies. In lieu of some money, anyone can be declared as the best and hence misguidance to the patients cannot be ruled out. The flow of patients to a health care facility can be enhanced by financing the advertisements and not by actual quality work and results in increasing medical business manifold.  They do not contribute to much needed medical infrastructure and merely redirect patients to existing facilities. They may at the best be able to  become facilitators of the process that attract patients by advertisements and  result in skyrocketing cost to patients. Any of the Hospitals and doctors can be projected as the best, who tie up with these online aggregators in lieu of some money. Therefore the misguidance as well as increased costs is the two main drawbacks of such a lucrative arrangement of this new medical business.  They charge hospitals and doctors for advertisements ( sending more patients) and patients for channelizing them. In the resulting Zig-Zag path, patients are treated more on the basis of advertisements that are many times aired by our ‘Filmy Superstars’.

The health service aggregators have no skin in the game. Neither do they invest in hospitals nor do they have the responsibility of running a hospital, but they want the money which a patient will spend on their health in a hospital. They have conveniently created online apps and are ranked top on search websites. This whole process is against the values and ethics, which healthcare delivery is supposed to be.

Unregulated operations by unscrupulous online health service aggregators pose grave risk to public health.

   

Unregulated operations by unscrupulous online health service aggregators pose grave risk to public health.

  The damage caused by the unchecked presence of health service aggregators online is snowballing into a major healthcare crisis which the Union and state governments can ill afford to ignore. Instead of becoming a part of the solution, they have added to the problem by pushing aggressively for tests, surgeries and healthcare services without any medical requirement or prescription.

  There are plenty of  such apps which advertise about doctor consultations, quick surgeries and direct-to-consumer laboratory tests.

       This is where the trouble begins.

In one  case, the  healthcare aggregator suggested surgery for constipation. The mention of surgery scared the patient, who then approached a hospital where they advised him to improve his diet.

For a kidney stone issue, a healthcare aggregator suggested a laser surgery  to a patient without consulting a urologist. The laser surgery was done and the stones got stuck in his pelvi-uretery junction of the kidney-uretery track. He  became aware of it two weeks later when he had severe pain in his flank, because of which he walked in to a hospital after the app refused to acknowledge his concerns.

In all of these cases, the apps charged almost double the existing rates for surgeries. For a piles operation, in a general ward, a hospital charges between Rs 50,000-70,000, inclusive of medicines in a patient without co-morbidities. The apps charged between 1.25 lakh to 1.5 lakh, while the national public health insurance scheme Ayushman Bharat rates for such surgeries begin at Rs 10,000.

Ads are being run by online health service aggregators in newspapers and all  kind of  media.

For removal of kidney stones, hospitals charge Rs 50,000, while the apps charge upwards of Rs 1 lakh, while on the government’s Ayushman Bharat scheme, it is Rs 33,000.

Circumcision is priced at Rs 60,000 by the healthcare aggregators, when hospitals charge Rs 10,000 for a surgery such as this and it is Rs 3,000 for those availing it using Ayushman Bharat.

Their modus operandi? The healthcare aggregators have tie-ups with certain departments in certain hospitals, where after the app does the diagnosis, a doctor on their payroll is sent to the hospital to perform the surgery. After the surgery, the doctor walks away without any care and the patient is left at the hospital until he gains consciousness. At which point, if there is any immediate post-operative care, the nurse concerned does it based on the instructions of the doctor who left. Then the patient checks out.

    A fee is paid by these healthcare aggregators to these hospitals for use of the premises for the surgery. In most cases, they approach smaller hospitals where either the top administration turns a blind eye towards these activities.    Sometimes, the  doctor who performed the surgery may not be  on their rolls, but that from a healthcare aggregator.

 “The health service aggregators  have no skin in the game. Neither do they invest in hospitals nor do they have the responsibility of running a hospital, but they want the money which a patient will spend on their health in a hospital. They have conveniently created online apps and are ranked top on search websites. This whole process is against what healthcare delivery is supposed to be,” said Dr Jagadish Hiremath, CEO of ACE Suhas Hospital in Bengaluru.

Government rules prevent hospitals from advertising or soliciting for surgeries, pointed out Hiremath, but these companies live on advertising.

Such health care aggregators are feeding off hospitals and they need to be regulated. “If you remove the advertisements, these companies don’t exist. They have no physical presence except for a few labs or clinics,” he added.

“The problem is getting compounded by these discounts and offers for unnecessary medically and unwarranted testing in the name of wellness/immunity packages. It is a price war to offer maximum number of tests at lowest prices which is totally meaningless,” highlighted Malini Aisola, co-convenor of All India Drug Action Network (AIDAN)

These online health service aggregators have added to issue of illegal pathology laboratories mushrooming all over, pointed out Dr Jagadish Keskar of the Maharashtra Association of Pathologists and Microbiologists

  Almost all of them have roped in big names as brand ambassadors – actor Hrithik Roshan, Amitabh Bachchan, singer Guru Randhawa, Rahul Dravid, actor Sonu Sood, actor Rajat Kapoor,  Neha Dhupia, Yuvraj Singh and Randeep Hooda to talk about specific health issues and MS Dhoni.

   “They have all these famous names as brand ambassadors as if they will perform the surgeries or look at your blood in a lab. This confuses the public, who are already bombarded with too much information,” quipped Hiremath.

     Consumer Drug Advocacy group All India Drug Action Network (AIDAN) argued that the direct-to-consumer advertising has to stop completely. “It is too dangerous in healthcare. Aggregators are inducing demand when people are at their most vulnerable due to the pandemic. They are pushing promotions and offers on tests and surgeries and healthcare services without medical assessment or prescription,” said Aisola.

There is a danger particularly with surgeries, contended Aisola, because this could lead to bypassing medical opinions and identifying alternative treatments. When doctors, hospitals and labs associate themselves with the aggregators, there are ethical issues too, she pointed out.

The practice of doctors associating themselves with these healthcare aggregators have alarmed several doctors’ associations. Association of Minimal Access Surgeons of India (AMASI) wrote to its members stating that any member who has made such a contract with healthcare aggregators should disengage immediately failing which a member found to be in contract thereafter may be liable for disciplinary action by regulatory authorities.

They warned that any litigation arising from such practices will not be defended by the association during legal process by way of expert opinion or otherwise.

“It jeopardizes adequate clinical judgment by a trained person regarding need for surgery and decision as to the type of surgery that would be optimum for the particular patient. The apps are made for the sole purpose of making money,” said the AMASI notification.

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CJI Ramana’s Concern about Violence against Doctors: too Mild a Remedy, Need Concrete Action


            

            While violence against doctors should be a concern to everyone, more so for the public, but sadly everyone in society has preferred to take advantage and reap benefit of the situation at the cost of doctors. Government has remained more or less indifferent, whereas people don’t have minimum basic health amenities and doctors have become punching bags for inept health system.  Law industry has been enormously benefited financially due to medico-legal cases against doctors. Media and celebrities have sold their shows and news items not by good ground work, but by sensationalizing and mischaracterizing the real basic issues, airing one single incident as generalizations.  An atmosphere of mistrust has been generated against medical profession. Administrators and Industry have put themselves on higher pedestrian by selectively projecting the genuine failures and mistakes of doctors.  Local goons have blackmailed doctors over genuine complications and the natural deaths occurring in hospitals.  There is a little token action by police after routine incident of violence against doctors. Consequently medical business has thrived whereas medical profession is suffocated and art of medicine has been dying a slow gradual death.  Actually public needs to be concerned as the society itself is going to suffer in the long run,  not realizing  that people themselves are responsible for their health problems and not the doctors. 

     At this stage, Chief Justice of India N V Ramana on Saturday expressed serious concern over rising violence against upright and hardworking doctors and lodging of false cases against them.  The show of concern is nice gesture, as problem is clearly evident to all, but merely  expressing a concern at this stage is too mild a remedy.  When cancer is in late stages and  needs a radical surgery,  applying an ointment will not work.

Rising violence against doctors saddening, they deserve better: CJI Ramana            

Rising violence against doctors saddening, they deserve better: CJI Ramana

Chief Justice of India N V Ramana on Saturday expressed serious concern over rising violence against upright and hardworking doctors and lodging of false cases against them. The CJI said that he would also like to pay his tribute to the unending spirit of doctors, who work tirelessly round the clock for their patients. Doctors are mentors, guides, friends and counsellors. They should always remain active members of society, and solve problems faced by the people,” he said. The CJI said, “I am extremely saddened to witness rising violence against doctors. Several false cases are being lodged against upright and hardworking doctors. They need a better, and more secure, working environment.  This is where professional medical associations assume great significance. They have to be proactive in highlighting the demands of doctors.”  The CJI also expressed concern about the healthcare system in India and said that more than 70 per cent of the population resides in rural areas where people don’t have minimum basic amenities, forget about the comfort of corporate hospitals.

“Even Primary Health Centres (PHC) are also not properly equipped, if there is a PHC there are no doctors and if there is a doctor, there is no PHC. If both are there, there is no infrastructure. This is the situation in this country and in this scenario this type of affordable technique of detecting cancer through ultrasound at the preliminary stage is very helpful,” the CJI said.

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A comparison of imparting Justice Vs Health: Grave injustice to medical professionals


        Justice is needed for satisfaction of soul and peaceful mind, is of same importance what is to the health of body. Justice delayed gives a sense of hurt and pain to soul. Pendency in courts simply reflects the grave injustice people are living with.

 Pendency in courts casts a ‘pall of gloom’, presents a hopeless situation: AG

          Justice and Health- Both are crucial for happiness of the living beings as well as society as a whole.  Hospitals are full of patients and so are courts with litigants. None of the people go to hospital and courts happily and everyone invariably wants early relief.

   Compare the situation in courts with a hospital.  Once a patient visits hospital, he will be treated almost instantaneously; irrespective how many patients’ doctors might have to examine in a day or night. There is almost nil pendency in hospitals, be it day or night, emergency or routine cases.

     Now can we expect similar treatment at courts? Do the people visiting courts are imparted justice in real sense.  Doctors get few minutes to decide. Most of the time, for the investigations and the treatment few visits are required. But there is no pendency. In Government hospitals, even appointments are not given. A doctor sitting in outdoor will see hundreds of patients. On emergencies night duties, doctor will not be able to count how many he/she has stabilized or numbers treated.

      Even in such chaotic systems, doctor can be punished, dragged to courts or assaulted for unintentional mistakes, that are  almost always secondary to load of patients or inept infrastructure.

     The work at hospital continues day and night, 24 hours and 365 days, despite almost always lesser number of doctors and required manpower. Systems in hospitals  are designed and maintained meticulously   to have no pendency what-so-ever situation is.   Larger number of patients go back home treated well and very few unfortunate patients are unable to recover, but still whatever is required- is done invariably.

Pendency in courts casts a ‘pall of gloom’ , presents a hopeless situation: AG

NEW DELHI: India’s top law officer K K Venugopal on Friday said litigants’ fundamental right to speedy justice lay in tatters and implored country’s top judges to take drastic measures to arrest their waning confidence in justice delivery system caused by monstrous pendency of 4.8 crores cases, many for decades. When we look at the pendency, a pall of gloom settles. We find that we are in a hopeless situation,” Venugopal said, “How has the justice delivery system deteriorated to this extent? If you look at the pendency over the years, we realise that over a lakh of cases are pending for more than 30 years at trial court level and 10-15 years in HCs. How do you believe that so far as litigants are concerned they would have confidence in the justice delivery system?” “But against whom the poor litigant can complain, or an under trial who is incarcerated for a number of years which he would have undergone had he been convicted and punished? Do they file a case for enforcement of their fundamental right? But against whom?

44 million pending court cases: How did we get here?

       There are about 73,000 cases pending before the Supreme Court and about 44 million in all the courts of India, up 19% since last year.

According to a 2018 Niti Aayog strategy paper, at the then-prevailing rate of disposal of cases in our courts, it would take more than 324 years to clear the backlog.

Grave injustice for medical professions:

  1.  A doctor making wrong diagnosis (gets few minutes to decide) can be prosecuted, but courts giving wrong verdicts (get years to decide) are immune?

     2. Compare the remuneration of lawyers to doctors. Doctors gets few hundreds to save a life (often with abuses) and lawyers can get paid in millions (happily).

      3. Doctors treat the body and larger is still not fully known about mechanisms. Still doctors can be blamed for unanticipated events. Whereas  law is a completely known and written subject.

   4. If health is citizen’s right so should be a timely justice.

         Despite doing so much for patients, still people’s behaviour to doctors and hospitals is not respectful. Doctors are punished for slight delays and people and courts remain intolerant to unintentional mistakes. But people can’t behave in the same manner to courts and legal system and keep on tolerating the blatant injustice for years. 

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

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 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

   

Why buying a medical college seat & paying millions may be a blunder?


    The painful incident of Dr Archana Sharma’s Suicide unmasks the everyday struggle of the doctors in the present era. Her supreme sacrifice depicts the plight of doctors- being undervalued and demonized, forced to work as a sub-servant to bureaucrats, irresponsible policing, blackmail by goons and vulture journalism-all have become an accepted form of harassment.  Her suicide has unveiled the despondency, moral burden of mistrust that doctors carry. Her death is the result of the apathy of fair justice that eludes medical community. Sadly, the society is unable to realize its loss.

    Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment.  It may not be a good idea to opt for a medical career any more. In the present circumstances, when doctors themselves are doubtful about the advice for choosing medical career, some people are naïve enough to spend millions on securing an expensive medical college seat.  Problems faced by doctors are not only innumerable but are also so exceedingly complex that they are difficult to be analysed. Doctors feel so disgusted   about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession.

Disadvantages of being a doctor, Drawbacks of Medical profession: 

Choosing medical career  or being a medical professional  a disadvantage to doctor in comparison to other professions?

  1. Medical courses are comparatively lengthy and expansive study course and difficult training with slave like duties. “enslavement of doctors”.
  2. Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialize. Because of lesser seats in post-graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice.  They have to just flow with system ultimately.

3.Hostile environment for doctors to begin: Suddenly young and bright children complete  training and find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.

  • Difficult start of career: After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and half treats them as cheats and dishonest. Their work is seen with suspicion and often criticised.
  • The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient, keeps mind of a doctor occupied.
  • Blamed for all malaise: The society gets biased because of the   media reports and some celebrity talking glib against medical profession. The blame for inept medical system, administrative failure and complexity of medical industry is conveniently loaded on doctors. These lead to formation of generalised sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
  • Personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
  • Risk to doctor himself: Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include   tuberculosis and other bacterial and viral illnesses. Radiologists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.
  • Unrealistic expectations of society:  Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative every day is enough to spoil the mood for the day.
  • Retrospective analysis of doctor’s every action continues all the life: It could be by patients and relatives every day in the form of “Why this was not done before?” Every day irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. If unfortunately there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.

The decision taken in split seconds will be questioned, which  in retrospect  may not turn out to be the best one. But later retrospective analysis along with wisdom of hindsight with luxury of time  (in courts) may be labelled as wrong if a fault-finding approach is used. This along with general sentiment and sympathy with patients makes medical profession a sitting duck for lawsuit and punishments. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation would be full and almost permanent.

  1. Physical assault, routine instances of verbal abuse and threat are common for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. Recently, even female doctors have not been spared by mobs. Silence of prominent people, celebrities and society icons on this issue is a pointer towards increasing uncivilized mind-set of society.
  2. Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.
  3. Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession:  It is heart-breaking to watch  zero fee and fixed commission ads on television by lawyers in health systems in certain developed countries. They lure 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 disadvantage for medical profession.
  4. 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, which use pressure tactics to get their own way.

       It may be a  naïve idea  or just a blunder to pay millions to be a doctor.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

‘Doctor- Save Yourself’: Court Convicts Doctors For Operating Woman Without Ventilator


A Judicial Magistrate First Class court in Bidar district of Karnataka recently convicted three doctors for causing the death of a woman who was operated on by them without having a ventilator facility in the hospital and other lifesaving equipment.  This was despite the fact that  the committee constituted by the District Surgeon to verify the allegation of medical negligence in its final report has said there is no negligence on the part of the accused during the performance of the LAVH surgery and also shows  *how the accused have tried to save the deceased.”*

What is worrying for the doctors is that every death during medical treatment can be a blame against the doctors. If the courts were to impose criminal liability on the hospital and doctors for everything that goes wrong, the doctors now should be more worried about their own safety than giving all the best treatment to their patients.     Both Government and Private  small hospitals carry out  thousands of routine surgeries every day. Occasionally complications may arise  in simplest looking procedures – for example even in   normal deliveries; what to say about routine surgeries.         How many hospitals (Government and private) in districts, town in peripheries are equipped with a ventilatory support system?  Perhaps  they are too less, although an honest count would  be some  interesting data.  Still, surgeries of the type mentioned are conducted  routinely  in almost all of these small centres.

So based on one incident of this kind, the thousands of surgeries done in such areas are going to be affected. In other words, doctors will not dare to conduct surgeries in peripheries.       As per the verdict of the court, many of the surgical speciality’s doctors in periphery are indulging in blameworthy activities every day in their routine work. Why should they risk their lives and profession in such circumstances?   That raises  another question , as many  Government  Hospitals are also without ventilators in the periphery. Should Govt doctors also  refuse surgeries without an ICU setup?  Any Surgery or even normal delivery in rare circumstances can get complicated and  the patient may require ventilator. Usually anaesthetist use Ambu-bag for an emergency situation and transport the  patient to other facility. So absence of a  ventilator is not life threatening in a real sense.     In peripheries, a large number of  deliveries are conducted  by ANMs, and nurses, and complications may arise occasionally.  So what are the facilities expected and available at a sub-centre? In reality   almost nothing is available.      Merely having a ventilator  does not solve the problem and  is not enough . The hospital  requires much more  arrangements to keep a patient  on ventilator.  Do all Govt hospitals where surgeries are  being done have ventilator and trained doctors  and support staff to operate those ventilators? It needs round the clock trained  doctors  and nurses, ABG  machine, portable X-ray , bed side Echo dialysis etc. Doctors in ill-equipped Govt   centres  are forced to conduct deliveries.  What should be the SOP in such circumstances? A real and honest data would be an eye opener and interesting.

Doctor need to  ponder over the issue of saving themselves before they save the patient.

 

 

Medical Negligence: Karnataka Court Convicts Three Doctors For Death Of Woman Operated Without Ventilator Facility & Other Life Saving Equipment* “A Judicial Magistrate First Class court in Bidar district of Karnataka recently convicted three doctors for causing the death of a woman who was operated on by them without having a ventilator facility in the hospital and other life saving equipment. BIDAR: Four people, including three doctors, have been handed jail terms and slapped with fines by a local court for a botched surgery which claimed the life of a woman.The II Civil (senior) and JMFC Court judge Abdul Khadar sentenced well-known medical practitioners Dr Rajshree Biradar and Dr Vaijinath Biradar, and Saibanna, to two years imprisonment and fined them Rs 10,000 each. If they fail to pay the fine, they will have to serve an additional six months in prison. Dr Rajshekar Patil was sentenced to six months imprisonment and fined Rs 5,000. He will have to serve additional imprisonment of one month if he fails to pay the fine.The case dates back to October 12, 2014, when Sampavati, wife of Ghaleppa Auradakar, got herself admitted to Sushrut Nursing Home in the city for a hysterectomy procedure. But after a five-hour surgery, she died due to alleged medical negligence.However, without disclosing her condition to the family, she was shifted to Dr Rajshekhar Patil’s Shree Hospital in an ambulance. Dr Patil continued the treatment without disclosing her condition, it was alleged in the chargesheet.

Nursing home was negligent in not having ventilator: Court

Later, it was revealed that Sampavati had died at Sushrut Nursing Home itself due to the lack of ventilator facility. The court, while convicting the accused, observed that the nursing home authorities were negligent in not having a ventilator facility for such a risky procedure.

Advantages-Disadvantage of being a doctor

25 factors- why health care is expensive

     REEL Heroes Vs Real Heroes

     21 occupational risks to doctors and nurses

     Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Typical Story of Blackmail by Goons &Vulture journalism #Dr-Archana-Sharma-Suicide


       Painful story of Dr Archana Sharma Suicide unmasks the everyday struggle of the doctors in present era. Although not ideal but being undervalued, dis-empowered and demonized, forced to work as sub-servant to bureaucrats are considered new normal and is an accepted form of harassment.  Fatigue and burnout are thought to be routine side effects of being a doctor or nurse. Venomous media, celebrities, film stars and prominent personalities have left no stone unturned in spreading hatred and creating an environment of mistrust against the medical profession.  They project   single stray incident   as an example and portray poor image of medical profession as generalization just to earn money and fame for themselves. Doctors have become prone to the verbal, physical as well as legal assaults.  Dr Archana Suicide unmasked an organised crime and propagators were local goons, politicians and vulture journalist, who usually managed an orchestrated racket to blackmail the doctors and extort money. Doctors being soft targets because of their nature of work as they deal with life and death.   Any death gives them opportunity to all to blackmail the doctors on the pretext of negligence, a legal weapon used by law-enforcers.

          Dead doctor’s husband demands action against ‘vultures’ and ‘blackmailers’

          Dead doctor’s husband demands action against ‘vultures’ and ‘blackmailers’

       JAIPUR: The husband of gynaecologist Dr Archana Sharma, who committed suicide on Tuesday, lodged an FIR against one Shiv Shankar Ballya Joshi for exerting pressure on the doctor and organising protests in her hospital. Hours before his transfer, Dausa SP Anil Kumar said police have seen the CCTV footage wherein Joshi was belting out abusive slogans against the doctor in the hospital. Police said they were investigating Joshi’s role in the case. The entire incident began when a 22-year-old woman was brought to Sharma’s Anand Hospital on Sunday night with labour pain. Though she was taken to the labour room, her condition deteriorated allegedly due to excessive bleeding and she died on Monday. On the same day, Dausa police registered an FIR under Section 302 (Murder) of the IPC which names Dr Archana Sharma and her husband Dr Suneet Upadhyay. The FIR put Rajasthan police in a tight spot because several doctors alleged that cops could have filed the FIR under Section 304A (causing death by negligence) of the IPC, instead of slapping murder charges on doctors. 4/1/22, 3:20 PM Rajasthan: Dead doctor’s husband demands action against ‘vultures’ and ‘blackmailers’.  Kumar, however, said the police only registered the FIR on the basis of the complaint filed by the patient’s family. In an emotional video message, Dr Upadhyay alleged that Joshi had promised the family a hefty compensation and brought them back with the body to the hospital. “Joshi called other BJP leaders to the hospital too. Joshi has been trying extortion and blackmailing in the hospital,” he said, adding that the police have been shielding Joshi due to a senior BJP leader of Dausa. Sharma’s husband Dr Suneet Upadhyay in his FIR said that some “vultures” played politics on the patient’s body as they gheraoed the hospital and forced the local administration to file a case of murder against the doctor. Upadhyay alleged that Joshi played a key role in this entire affair. He has been accused in the FIR of threatening the hospital multiple times in the past. As per the FIR, many complaints were filed against Joshi at the police station, but cops took no action against him, which further emboldened the accused. Upadhyay said Joshi was hurling invectives during the protest at the hospital and his wife could not tolerate such insults because she was a reputed surgeon who had saved the lives of several women and children. He said she was stalked by fears that Joshi could send her to jail even though she was innocent. The complaint also mentions that Sharma read a report of the incident in a local newspaper, but there was no mention of the hospital’s version there.

          According to Upadhyay, the family members of the deceased patient had returned from the hospital with complete satisfaction because they had witnessed the doctors struggling for nearly two hours to save her life. He said the family of the deceased patient were preparing for her last rites when Joshi stepped in and brought the body back to the hospital. Joshi allegedly called up people over the phone and gathered a large crowd at the hospital. He wanted to file a case of murder against the doctor even though the family of the patient had not given any complaint. The FIR states that vultures like them have made the lives of doctors in the country very difficult and told cops to act against such blackmailers. Dausa police said they have booked Joshi under Section 306 (abetment of suicide), 304 (extortion) and 384 (extortion by threat of accusation of an offence punishable with death or imprisonment for life, etc) of the IPC. Police said Joshi is a local leader, whereas, they are probing the journalist’s involvement.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

The Book-‘At the Horizon of Life & Death’:Blackmail of Doctors by opportunist goons, legal industry, Vulture Journalism


      While doctors are usually blamed for any mishap, be it natural poor prognosis or genuine complications, rarely people get to know their side of the story — how a dying patient affects their psyche, how they deal with these patients and their kith and kin, what are the kinds of abuse and threats made when they are not able to save a life despite their best efforts.  Book describes stories the blackmail doctors face from opportunist goons, legal industry and vulture kind of journalism. Every day blackmail by legal industry, journalist and local goons, similar to what Dr Archana Sharma went through and others doctors are  facing have been described.

         Dr Pankaj Kumar, Director Critical Care at a Delhi Hospital, India has come out with an insightful account of these very aspects of a doctor’s life.

    The 300-page book (English) contains 20 stories divided into three parts viz – Larva & Pupa Syndrome, Hope & Fear & Medical Lawsuits. The book is available worldwide on Kindle Amazon, Apple, Barnes & Noble, Tolino, Kobo, Scibd, BorrowBox, Baker & Taylor , Vivilo, Overdrive  etc.

         His book ‘At the Horizon of Life & Death’ is a Reality Fiction that reflects the sensitivity involved in dealing with patients facing death.

     Through the eyes of its protagonist Dr Anand, the book captures significant moments in the treatment trajectory of critical patients. The book tries to create awareness regarding pertinent issues faced by the medical professionals like demoralisation, expensive medical education, the extreme pressure and suicidal ideation, the plight of the nurses and support staff, assaults and violence and the medico-legal intricacies involved in day-to-day practice among others. The author has also taken care to guide aspiring doctors to make well-informed career decisions.

     Part One (Larva & Pupa Syndrome)-  talks about the expensive medical education, and the issues students face in medical college.

    Part Two (Hope & Fears) talks about the beginning of doctors’ professional journey, the disease demons they face while dealing with critical patients, dilemmas of doctors and patients near death situations.

    Part Three (Medical Lawsuits) is about how doctors are always working under the threat of medico-legal lawsuits.

        While stories are fictional, the scenarios and the problems in them are very real — things that he faced or saw his colleagues facing.

     Medical profession has become victim of mistrust generation and blame culture. Everyone keeps harping about the few black sheep in the community, while larger good work of doctors is not highlighted enough.

    The stories span from Dr Anand’s initial days in the emergency room and capture his struggles in complex medico-legal scenarios over the next four decades. This book is an effort to bring back focus on the treatment of the patient as opposed to the mistrust, legal frameworks and policies surrounding the healthcare practice.

Suicide by Dr Archana Sharma has exposed the blackmail; medical professionals are going through in current era. Doctors have become sitting ducks for punishments complaints, blackmail, and legal complexities besides every day harassment. Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment.  It may not be a good idea to opt for a medical career any more.

More naïve would be to pay millions to be a doctor.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Sitting Ducks for Blackmail- May be Unwise to Become a Doctor 


      Suicide by Dr Archana Sharma has exposed the blackmail; medical professionals are going through in current era. Doctors have become sitting ducks for punishments complaints, blackmail, and legal complexities besides every day harassment. Negligent police, indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment.  It may not be a good idea to opt for a medical career any more. In the present circumstances, when doctors themselves are doubtful about the advice for choosing medical career, some are naïve enough to spend millions on securing an expensive medical college seat.  Problems faced by doctors are not only innumerable but are also so exceedingly complex that they are difficult to be analysed. Doctors feel so disgusted   about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession.

More naïve would be to pay millions to be a doctor.

     Stark reality of complex medical scenario hits the studious and meritorious medical students on the face when they come out of college and start working in present environment. After a difficult time at medical college with slave like duties, an unsettled family life and with no money, these brilliant doctors begin their struggle. They work at various hospitals to gain more experience and slowly acclimatize themselves to the real problems of this profession. They realize that the actual medical world is far different than what was apparent from inside the medical college. Suddenly they find that their lives undergo a sea change. The goals that were taught in the medical college are now just not enough and they actually constitute only smaller part of a much larger system. And the scenario seems to getting worse for doctors with each passing day.
There is increasing discontentment amongst doctors because of complex and punishing system in addition to the unrealistic expectations of society which takes the enthusiasm out of these young bright doctors. Every day now, the informal discussions with colleagues regularly dwell more on problems faced by doctors, rather than real goals. There are routinely instances of verbal abuse and threat for no fault of theirs. Some unlucky ones get physically assaulted as well. Sometimes there are threats of dragging the doctor into a lawsuit which sometimes do really happen. Even if court, after years of deliberation, does decide in favour of the doctor, the harm to the doctor in the form of mental harassment and tarnished reputation is already done and that is something which cannot be undone even after he has been proved innocent.
Even if such events don’t happen to everyone, the very fear of such possible scenarios and their possible complications always lurks in the back of the mind and affects the treatment because the doctor tries to be doubly safe. The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient always colours the final decision in treatment. Many become punching bags in place of inept medical system and invisible medical industry. Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment.
And if these were not enough, these problems have been further compounded by unnecessary utterances by celebrities against doctors, negative projections by media who never acknowledge the great work done day and night by doctors. Stray mistakes by some doctor, or treatment failure due to a poor prognosis and sometimes due to system failure are projected and widely highlighted by media and celebrities to tarnish image of all doctors .Though these do sensationalise their news and promotes their business, but the repercussions are heavy and it breaks the trust of the public in their doctors. This eventually does harm to innocent public in the long run but has also done enough irreparable damage to the medical profession.
If children of current generation do not hold the profession in high esteem, then obviously they wouldn’t want to be part of this profession. And if brilliant students shun this profession, then how would society get good doctors? If there is always fear in their mind, no one can do justice to his job and this you’ll all agree, applies to all professions

Disadvantages of being a doctor, Drawbacks of Medical profession: Choosing medical career  or being a medical professional  a disadvantage to doctor in comparison to other professions?

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Any Fine Morning can be Harbinger of Doomsday for doctors #lady-doctor-suicide


Working of a doctor and nurses is not free from risk to themselves which can be verbal, physical as well as legal assaults. Everyday globally, the doctors and the nurses greet the new day and return to their work of taking care of their patients, knowing well the risk involved. None of the   doctors can guess which one fine morning becomes a harbinger to their doomsday, especially when serving an anarchic and hostile society. No doctor can anticipate which one patient can cause deadly harm to health care workers, while trying to save the one.  Unfortunate incident of PPH (Post-partum Bleeding – a natural complication of pregnancy) and subsequent agitation by mob and over-reactive FIR by hostile Police was enough for a brilliant Obstetrician to commit suicide in Jaipur.  Possibly doctors are not assured of getting justice anymore from our system.

Jaipur- A woman doctor booked for death of a pregnant woman in Rajasthan committed suicide

Jaipur- A woman doctor booked for death of a pregnant woman in Rajasthan committed suicide

Jaipur, Mar 29 (PTI) A woman doctor, who was booked for allegedly causing the death of a pregnant woman at a private facility in Rajasthan’s Dausa district, committed suicide on Tuesday, police said. Jaipur, Mar 29 (PTI) A woman doctor, who was booked for allegedly causing the death of a pregnant woman at a private facility in Rajasthan’s Dausa district, committed suicide on Tuesday, police said. Jaipur, Mar 29 (PTI) A woman doctor, who was booked for allegedly causing the death of a pregnant woman at a private facility in Rajasthan’s Dausa district, committed suicide on Tuesday, police said. According to police, the pregnant woman died at the hospital run by Dr Archana Sharma and her husband on Tuesday. An FIR was registered against Archana at the Lalsot Police Station after family members of the pregnant woman held a demonstration outside the hospital and demanded immediate action against the erring doctor. Stressed over the FIR, Archana hanged herself to death, police said. “The doctor was booked for the death of the pregnant woman due to negligence in treatment. Today afternoon, the doctor hanged herself to death at her residence above the hospital,” Additional SP (Dausa) Lal Chand Kayal said.

    The risk is generally underestimated, although often it may be major risk to life.  Majority of people, society and governing bodies and even doctors themselves do not perceive or acknowledge the possible harms to health care workers in present era.  But since these risks are increasing exponentially, they should be known to students, who want to take medicine as a profession. There are lesser set procedures, lack of awareness, not protective equipment or hostile society, lack of governance and laws and doctors continue to work in dangerous environment.

         Doctors have become punching bags for all the malaise prevalent in the system. A failing system which is unable to provide health to the people and security to doctors. The rickety system hides behind their hard working doctors and presents them as punching bags. The impunity with which attendant easily and brutally assault doctors is really appalling, should be shameful to law enforcing agencies.

            Role of media, celebrities, film stars and prominent personalities in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable. They project   single stray incident   as an example and portray poor image of medical profession as generalization just to earn money and fame for themselves. Doctors need to be careful and remain careful about saving themselves from verbal, physical as well as legal assaults.

Doctor- ‘save the patient but to save themselves also’.

Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

Man Jailed for Abusing Lady Doctor


         In present era,  most of the time, a lenient view is taken  against assault of doctors on the grounds of  emotional circumstances  of relatives and sympathy towards patients, even in cases of blatant injustice imparted towards doctors and nurses. Not   infrequently, assaults of doctors are taken as routine incidents committed under disguise of perceived negligence and sympathy towards patients. The culprits are able to commonly get away with it.

   But this businessman who abused a lady doctor has not been proved to be lucky, at least till this time. He was handed over a jail term of 6 months. Rightly so, courts need to aim at imparting justice and not judge on the basis of projected disturbed emotional state.

         Doctors have become punching bags for all the malaise prevalent in the system. A failing system which is unable to provide health to the people and security to doctors. The rickety system hides behind their hard working doctors and presents them as punching bags. The impunity with which attendant easily and brutally assault doctors is really appalling, should be shameful to law enforcing agencies.

Man gets six-month jail for abusing lady doctor

            Role of media, celebrities, film stars and prominent personalities in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable. They project   single stray incident   as an example and portray poor image of medical profession as generalization just to earn money and fame for themselves. Doctors need to be careful and remain careful about saving themselves from verbal, physical as well as legal assaults.

  Man gets six-month jail for abusing lady doctor

The incident had taken place on 23 Nov 2017 when Rohinton Umarigar, who was at the Parsi General Hospital for his mother’s treatment used abusive language with the woman doctor who was in charge of the ICU

A Girgaum magistrate court refused leniency to a 52-year-old who used foul language with a woman doctor in 2017 and sentenced him to six months of simple imprisonment. It stated that unwarranted leniency to him would send a wrong signal to society and that he had used unparliamentary language to insult the dignity of a woman.

The incident had taken place on November 23, 2017, when the man, Rohington Umarigar, was at the Parsi General Hospital where his mother was undergoing treatment. He used abusive language with the woman doctor who was in charge of the ICU.

The Nepean Sea Road resident had sought leniency and requested that the court release him by imposing a minimum fine and on a bond of good behaviour. He told the court that he was the only breadwinner of his family. Umarigar’s advocate told the court that the incident occurred at the spur of the moment when his mother was ill. The court said the punishment under Sec 509 of the IPC (word, gesture, act intended to outrage modesty of a woman) was enhanced by the legislation in 2013 looking at the time and seriousness of offences committed against the modesty of women. The court noted that Umarigar had misbehaved a second time with the doctor, which means it was intentional.

“Whenever such type of offence is committed against women, it is against their right to sexual integrity, dignity. It is linked to their right to privacy…in the present matter also, the accused has used unparliamentary words to insult the dignity of woman. He is in his 50s and knows the consequences of his act,” Magistrate Nadeem A Patel said. The court further said that while enhancing the punishment, it was the intention of the legislature to penalize the offence of outraging a woman’s dignity, either physically or verbally. Therefore, in such cases, unwarranted leniency shown will send a wrong message to society. It also imposed a fine of Rs 1,000 on the man.

The man had claimed that he had made a complaint to the hospital management against the doctor for negligence and that this was a counter-complaint. The court refused to accept this defence. It said that even for the sake of argument if it were to be assumed that she had been negligent in her own duty, it did not give him the right to abuse a lady doctor. It relied on the testimony of the victim, as well as her three colleagues at the hospital who testified about the incident.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

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