Blog

Violence against doctors: No support – Saviours need to save themselves


 

More of a law and order issue, the physical assault on doctors reflects that they are serving an uncivilized society.  Such news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession. The medical students need to think, why they wish to enter medical profession in such an unsupportive environment?

     Strangely media, courts, prominent people, celebrities, human right commission, right activists are little concerned about the blatant injustice done towards doctors.  This again brings forth the hypocrisy of our society and law enforcement agencies, which otherwise cry hoarse about human rights, but practically doctors (while they save others), need to fend for themselves when ugly situations arise.  

NEW DELHI: The Central government has decided not to enact separate legislation for prohibiting violence against doctors and other healthcare professionals, the Rajya Sabha was informed on Tuesday.

In a written reply, Union Health Minister Dr Mansukh Mandaviya said that a draft of the Healthcare Services Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019 was prepared and was also circulated for consultations.

“Thereafter it was decided not to enact a separate Legislation for prohibiting violence against doctors and other health care professionals,” he said to a question on the reasons for the withdrawal of the Bill, which intended to protect healthcare professionals and institutions.

No separate law to prohibit violence against doctors & Health care workers

Mandaviya said that the matter was further discussed with relevant ministries and departments of government as well as all stakeholders, and an ordinance namely The Epidemic Diseases (Amendment) Ordinance, 2020 was promulgated on April 22, 2020.

However, the government, on September 28, 2020, passed the Epidemic Diseases (Amendment) Act, 2020 under which acts of violence against healthcare personnel during any situation were considered cognizable and non-bailable offences.

Speaking with TNIE, Dr Rohan Krishnan, National Chairman, FAIMA Doctors Association, said that there have been many cases of violence against doctors and health professionals in the past few months inside the government hospitals, but the union health ministry has not taken their demand to have a separate law for providing safety and security to healthcare workers and doctors seriously.

“The government needed us during the Covid-19 pandemic and came out with rules and regulations. We also felt safe and secure. But now that Covid-19 is declining and we were able to bring normalcy, the government is showing its true colours. It is shameful,” he said.

“The government is not standing up to its promise of bringing a separate law to prohibit violence against doctors and healthcare professionals,” he added.

“On the one hand, it has failed to provide mental and physical safety and security to the doctors and healthcare professionals; on the other hand, instead of having verbal communication with us regarding this matter, the government is denying any scope of providing a separate law in the future. This is a very serious issue. We will raise this issue at every level,” Dr Krishnan said.

Under the Epidemic Diseases (Amendment) Act, the commission or abetment of acts of violence or damage or loss to any property is punishable with imprisonment for a term of three months to five years, and with a fine of Rs 50,000 to Rs 2,00,000.

In case of causing grievous hurt, imprisonment shall be for a term of six months to seven years and with a fine of Rs 1,00,000 to Rs 5,00,000.

In addition, the offender shall also be liable to pay compensation to the victim and twice the fair market value for damage to property.

Since, law and order is a state subject, State, and Union Territory governments also take appropriate steps to protect healthcare professionals/institutions under provisions under the Indian Penal Code (IPC)/Code of Criminal Procedure (CrPC), the minister said.

To another question on the number of security guards hired/outsourced by government hospitals in the country, the Minister of State for Health Dr Bharati Pravin Pawar said that public health and hospitals are state subjects, therefore no such data is maintained centrally.

     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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Singed with hot rod to ‘cure pneumonia’- the child dies: Illogical distribution of health care


         In a heart wrenching and unfortunate incident from Bhopal (Madhya Pradesh), a 2.5 month child was singed with hot iron 50 times by a quack for treatment of pneumonia.  He died and   the incident appeared in newspapers, but similar kind of  treatments must be going on at many places and  gullible patients keep on suffering .The suffering is of two types; one, that they are deprived of correct treatment and other is the tremendous suffering because of such nature of cruel practices in the garb of  treatment.    

         That brings to the fore the basic question; why such type of treatments are being practiced and allowed to be conducted in 21th century. Why people allow  and consent for such treatments by quacks?

     These incidents simply reflect that the health system has not been able to travel  the last mile and  has failed to  touch the last man.

         Most important reason for such disparity is illogical distribution of health care.  Corporatization of health care has projected medicine as a purchasable commodity and consequently resulted in an Illogical distribution of health care

 People, who can afford, spend millions in the last few days of their life, just to have only a few more days to live. Resources spent in such a futile quest are equivalent to  thousands of times the money for food and medicines for the poor who lose lives for fraction of that expense.

It seems humanity has legalized the hoarding of medical care; give it to the rich, bundled with consumerism though not necessarily the needy. It is the same as hoarding of the food that is sold to rich, letting the poor die somewhere in the world without food, which remains invisible to all.

          Another worrisome aspect of the incident is  that  avoidance of people to  seek treatment from appropriate  clinics and hospitals. Anganwadi worker was there in the village, so it was possible  to seek help from the health system. Is the mistrust and malice  generated  by media towards  doctors and  medical professionals is the reason to  avoid seeking help from them?

BHOPAL: A newborn has died after being singed more than 50 times with a red hot iron rod in a bizarre ritual to ‘cure pneumonia’ in MP’s Shahdol district. A local anganwadi worker saw this horror being inflicted upon the child by a quack and persuaded the parents to take her to a hospital, say sources. They did, but it was too late. The baby’s body was exhumed on Friday evening for post-mortem examination. Even as police were grappling with this horror, a similar case was reported in a nearby village. This infant is in hospital. Police are yet to arrest anyone in either case and it’s not yet known if the same quack, a woman, was behind singeing both babies. The Child Welfare Committee has written to police to take action under section 75 of Juvenile Justice Act, but nothing has been done. When TOI spoke with Singhpur police, they said they were taking legal opinion on how to proceed with the case. An officer said they are waiting for the autopsy report to see what charges can be pressed. The baby who died was two and a half months old and suffering from pneumonia. Her parents live in Kathotiya village, around 520km from Bhopal and close to Chhattisgarh. “The infant was ‘torched’ as a method of ‘treatment’ on January 10.” Singhpur police station in charge, MP Ahirwar told TOI. The second incident happened in Samtapur villagee. The baby’s parents deny they put the girl through the burning ritual.

     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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Budget outlay on medical insurance up, public health infrastructure down


       Whether it is better to buy fish for years or provide people with fishing net? This applies to public health care system in India.  Times of India analysis points out the need to build and strengthen   the public health care system. Building of infrastructure for massive population requires funds, but ultimately the investment will bring down the cost of treatment and better delivery of health care to the country.

                     NEW DELHI: The health budget is good news for the private health sector as there has been a substantial increase in allocation for health insurance schemes such as the Central Government Health Scheme (CGHS), treatment for CGHS pensioners and the Ayushman Bharat scheme. Government’s own data has shown that the private health sector corners the bulk of the spending under these schemes, which saw a nearly 22% jump in allocation in the 2023-24 budget.

          In contrast, the allocation for schemes aimed at improvement in public health infrastructure has declined when adjusted for inflation. These include the National Health Mission (NHM), Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PMABHIM), human resources for health and medical education and Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).

The overall allocation for health after rising during Covid, has come down in real terms though it seems like an increase in nominal terms from Rs 83,000 in the budget estimates (BE) for the current year to Rs 86, 175 crore in BE 2023-24. The revised estimates (RE) for the current year indicate a 9% decline from the BE to Rs 76,370 crore. The allocation for insurance schemes, however increased substantially in RE 2022-23; more than 75% hike in allocation for CGHS pensioners from Rs 2,645 crore to Rs 4,640 crore and for the first time since the launch of Ayushman Bharat scheme, the RE is the same as the BE at Rs 6,400 crore. In the past, only about half the budgeted amount for Ayushman was getting spent. However, the allocation for all the public infrastructure schemes put together has been slashed by 16% in the RE for the current year. In comparison to the Rs 13,266 crore allocated for insurance schemes, which cover only a section of the population, about Rs 30,000 crore has been allocated for the National Health Mission and a separate Rs 6,500 crore for human resources for health and medical education, which was earlier part of the NHM budget.

         Most of the allocation for the insurance schemes usually ends up in the coffers of the private sector. Despite private hospitals accounting for only 46% of empanelled hospitals under Ayushman Bharat, for instance, they accounted for 54% of hospitals admissions and since private healthcare is more expensive, that could account for a much higher proportion of the money spent. Most CGHS beneficiaries too go to private hospitals as noted by Dr Rakesh Sarwal, who was advisor health in Niti Aayog, in a study of the scheme. Dr Sarwal stated that CGHS had a higher cost of service because of its greater reliance on private facilities. Incidentally, though the finance minister announced a mission to eliminate sickle cell anaemia, there is no separate budget line for it. Thus even the money for a totally new scheme might have to come from within the NHM budget, further eating into the allocation. The tertiary care programme, which provides for transfer to states for implementing national programmes on control of blindness, tobacco control, capacity building for trauma centres and for prevention and control of non-communicable diseases such as cancer, diabetes, cardiovascular diseases and stroke, has had its allocation slashed to just Rs 290 crore, less than the actual spending of Rs 300 crore in 2020-21, and 42% less than the allocation of Rs 500 in the last budget.

The budget for the establishment and strengthening of the branches of the National Centre for Disease Control and for preparation and control of zoonotic and other neglected tropical diseases and for diseases surveillance, which had gone up during Covid, has been slashed from Rs 71.6 crore to just Rs 55.6 crore, despite the WHO asking countries to prepare for future pandemics by strengthening surveillance. Even the budget for the Indian Council for Medical Research, which played a crucial role during Covid, has been slashed along with a cut in the overall allocation for health research.

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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Supreme Court simplifies  rules on passive euthanasia& Living Will


NEW DELHI: The Supreme Court on Tuesday modified its 2018 order on passive euthanasia to make the procedure of removal of (or withholding) life support from terminally ill patients less cumbersome for the patients, their families and the doctors by limiting the role played by government officials. While the requirement of setting up two medical boards — one primary and other review — to examine the medical condition of the patient has been retained, the SC has done away with the rule mandating that the district collector set up the review board. The court said both boards will be constituted by the hospital and there would be one nominee doctor of the district medical officer in the review board. The medical boards must take a decision on such cases preferably within 48 hours, it added.

While the current rules state that the consent of the judicial magistrate is required for conducting passive euthanasia, the new order by a five-judge bench of justices K M Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy and C T Ravikumar says the magistrate just needs to be informed. While making the procedure for passive euthanasia less cumbersome, the Supreme Court on Tuesday also simplified the process of making a “living will”, an advance directive by a person wishing not to be put on artificial life support. While the earlier rule stipulated that a living will had to be made in the presence of two attesting witnesses and countersigned by the jurisdictional JMFC, the new order says such a will can be attested by notary or a gazetted rank officer. The process prescribed in2018 was onerous as it not only involved family members and doctors but also a judicial magistrate and collector as well as setting up of two medical boards before removal of life support systems and there was no prescribed time period for medical boards to give their opinion. As per 2018 guidelines, in the event a person became terminally ill with no hope of recovery, the treating physician had to ascertain the authenticity of the case from the JMFC. If the physician was satisfied, the hospital then constituted a medical board consisting of the head of the treating department and at least three expert doctors with 20 years of experience.

If the medical board certified that life support system could be removed, the hospital had to inform the collector who then had to constitute another medical board comprising the chief district medical officer and three expert doctors. If the review board allowed withdrawal of treatment, it had to convey the decision to the JMFC. The JMFC then had to visit the patient and, after examining all aspects, decide on whether the euthanasia directive could be implemented. Modifying the order, the bench said that medical practitioners with five year of experience can be part of the medical board. The court also agreed with the petition that there was no need to involve JMFC in the process of preparation of the living will. Times View: The new guidelines have been issued because the earlier guidelines were proving to be unworkable. It is good that the apex court has taken a relook on the subject. It is entirely possible that even these new guidelines may need to be revised in future. But the principle must be about making things easier for consent-givers without increasing the risk of misuse.

     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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

 Supreme Court agrees to make Passive Euthanasia & Living Will rules workable


SC to tweak 2018 verdict to make passive euthanasia rules workable

NEW DELHI: The Supreme Court on Tuesday decided to “tweak” its 2018 verdict on passive euthanasia to make the procedure and guidelines fixed by it workable, and said that it may fix a time frame within which medical boards would have to submit reports to remove life-support systems from a terminally ill patient. Admitting that the procedure prescribed by the apex court in 2018 was very onerous and time consuming, a five-judge constitution bench of Justices K M Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy and C T Ravikumar sought suggestions from the Centre and senior advocates Arvind Datar and Prashant Bhushan to make it workable without compromising with the safeguards put in place by the court four years ago while legalising passive euthanasia. The process prescribed in 2018 not only involves family members and doctors but also judicial magistrates and collectors. Besides, two medical boards need to be constituted before life-support system can be withdrawn. The verdict said the living will, or advance directive for not putting a person on artificial life-support system, has to be made in the presence of two attesting witnesses and countersigned by the jurisdictional judicial magistrate of first class (JMFC). In the event of a person becoming terminally ill, the treating physician shall ascertain the living will’s authenticity from the JMFC. If the physician is satisfied, the hospital shall then set up a medical board consisting of the head of the treating department and at least three expert doctors. If the medical board recommends removal of life support, the hospital shall inform the collector, who shall then constitute another medical board comprising the chief district medical officer and three expert doctors. If the board allows withdrawing treatment, it shall convey the decision to the JMFC before allowing life support to be withdrawn. JMFC shall visit the patient and, after examining all aspects, may permit implementation of the directive.

      Seeking modification in the procedure, lawyers contended that time was crucial for terminally ill patients and the whole purpose of passive euthanisa was defeated due to the time taken by the process. That was the reason why there has not been a single case of passive euthanasia in the last four years despite it being legalised, they added.

Agreeing with their contention, the bench observed that dying in peace was dying with dignity, and suffering of a patient should not be prolonged due to the lengthy process. It said that the court could set a time limit for completion of the two-tier procedure without delay and also consider that a living be prepared like normal will without the mandatory presence of a judicial officer. The bench sought response from the Centre on whether it intended to frame a law for its regulation as the court had said in 2018. Paving the way for passive euthanasia, the apex court had in 2018 said, “It has to be stated without any trace of doubt that the right to live with dignity also includes the smoothening of the process of dying in case of a terminally ill patient or a person in PVS (persistent vegetative state) with no hope of recovery. A failure to legally recognise advance medical directives may amount to non-facilitation of the right to smoothen the dying process and the right to live with dignity.”

Supreme Court agrees to not involve judicial officers, collectors in ‘living will’ process

NEW DELHI: Amidst divergent opinions evading consensus on various points to make 2018 verdict on passive euthanisa workable on ground, the Supreme Court on Wednesday agreed in principle to keep judicial officer and district collector out of the process for making living will and setting up of medical board for removing life support system for terminally ill patients. Facing the onerous task to tweak 2018 verdict without modifying it and to continue with the safeguard put in place four years back, Justices KM Joseph, Ajay Rastogi Aniruddha Bose, Hrishikesh Roy and Justice CT Ravikumar are exploring ways to build consensus among parties, including the Centre, to make the process of making and executing living will or advance directive practical and less cumbersome for the patient. As the petitioner, represented by advocate Arvind Datar and additional solicitor general KM Nataraj, agreed that there was no need to involve judicial magistrate of first class (JMFC) in the process of preparation of will, the bench agreed that the living will can be attested by notary or a gazetted rank officer. As per 2018 verdict, the living will or advance directive, for not putting on artificial life support system, has to be made in the presence of  two attesting witnesses and countersigned by the jurisdictional JMFC. The court also in principle agreed that collectors be kept out of the process and will take a call on who should be entrusted with the task to constitute secondary medical board.

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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Comparing airline industry & health care is fallacious, an oversimplification; apples to musk-melons


 

 

The issue of patient safety has been gaining increased traction year on year and the issue is in right direction.  Hospitals, doctors and administration need to vigorously address shortcomings and strive toward minimum errors and desired goals of safety.   Patient safety is of paramount importance; therefore it is an serious issue. It should be achieved by good ground work and not by sensationalizing and mischaracterizing the real basic issues, transparent safety culture, adequate number of staff and resources.

There is a recurrent old argument and temptation to ask about why healthcare can’t be as safe as airline travel.   There can be many apt comparisons that may be possible between aviation and health care especially taking into account the risk involved. But the doctors who treat critical emergencies,  have  insight looking at life and death situations directly,  know  that comparing both would be just an oversimplification of the real basic issues.

  At most of the points, the comparison is a complete fallacy; and like comparing apples to musk-melons.

It is beyond doubt that air-industry maintains truly an impressive system which is well-designed to achieve the safety results that it does.  But , the kind of  comparison  that  some health care safety leaders make in which they compare the  mortality data of acute hospital care and airline fatal accident rates is more of a word play and not so appropriate. This comparison is dangerous because it misses the key points for improvement. Such comparisons  merely present over-simplified and convenient tool for the health quality experts, who themselves have never been a front line health workers at any point of time, but still pretend to pioneer the  quality in health industry.  For the quality improvement the leaders need to be grounded in the reality of emergency front line medicine to be really effective.

  1. Aircrafts  are engineered to be in the best possible shape before they fly. Patients, on the other hand, patients  are in the worst shape when they enter the emergency of the hospital.

Medicine is by nature, a much more risky work than flying along with vulnerability to death always.

  1. The aircrafts are required to regularly demonstrate that the performance of their critical systems meets or exceeds strict standards. If systems are not operating well the plane will not be allowed to fly.

But all the patients, (aeroplane metaphor) are already sick; doctors are expected to fly such aeroplanes, who are in crashed condition universally. Doctors do not have the luxury to replace any part.  For example, when doctors treat an elderly with heart failure, chronic kidney failure and pneumonia, they try to keep them “flying” despite multiple sub optimally functioning critical systems.

  1.  In other words, doctors have to fly crashed planes always on every day basis, something that never happens even once in aviation industry.
  2. Has any Pilot ever tried to fly  a plane in which engine power is only 25 percent of normal with  other systems are functioning  sub optimally  and  the fuel tank is leaking?  What will be standard procedure (SOP)  for Pilot to fly this plane? But everyday doctors try to fly such planes and they have to fly it no matter how many systems are non-functional.  Moreover, doctors can be sued on some flimsy grounds in case they fail or an accident happens in an effort to keep this plane in the air.  Treating a critical illness is like an effort to keep such planes in air with suboptimal functioning systems.

Obviously the comparison is a bit overzealous.

  1.   What would be chances that a fully checked plane with a trained pilot will crash after flight takes off. Now compare the chances of patient who lands in emergency, and treatment is started.

By a simple common sense, are two situations comparable?

Former has no chance (almost Zero percent) of crash whereas in a critical emergency patient, the chances of crash are 100 % to start with.

  1. Communication of passengers to the pilot about what he should do and what he should not while flying the plane is nil. Whereas doctors are continuously bombarded with google knowledge of patients and interference by relatives and questioned about every action.
  2.   Doctors are expected to make future prediction about what can happen, how he will be able to keep the crashed plane in the air and take consent, based on few assumptions. Doctors can be harassed and dragged to courts if such predictions fail.
  3. Airlines will always have full staff to serve promptly during a flight. The pilot will be totally dedicated to flying the plane, and will not fly without the co-pilot and crew. On the other hand, front line healthcare workers know it well the fact that patient safety incidents and errors tend to occur when they are struggling with staffing levels and feel grossly overworked.

Fatigue and overwork is too common scenario among front line healthcare staff in clinical settings.

  1. A pilot is also only ever going to fly one plane at a time. It is not realistic for a doctor or nurse to be allocated to just one patient, but the workflow is very different, with healthcare tasks frequently interrupted with new clinical issues and emergency situations. Consequently, insufficient staffing can have an acute effect on outcomes and the ability to perform safely.
  2. Aviation industry is too predictable and on the contrary, health care is combination of uncountable unpredictable risk factors, be it allocation of staff or risk of death or resource prediction and complexity of communication.
  3. Aviation is more of mechanical milieu, whereas health care deals with emotion and compassion. The two industries are vastly heterogeneous, and to say that safety in medicine should follow in the path of flying airplanes, grossly oversimplifies a complex problem.
  4.    Last but not the least; health care involves lot of financial uncertainties and arrangements. Needless to say, doctors carry the blame for financial hardship of the patients, even if they are not responsible for costs. The mammoth industry remains hidden and doctors are blamed as they are the only front man visible.
  5. Basic difference lies in the fact that patients are real living people, whereas airplanes are simply machines, whose codes and protocols are well defined and limited to within human capabilities. The importance of human contact, empathy, compassion, interact and listen to concerns, and the ability to spend adequate time with patients,  should be  always be the first pillar of promoting a culture of safety.
  6.   Exhortations by armchair preachers to learn oversimplified improvement examples from aviation can provoke considerable frustration and skepticism among clinicians exposed to the unique challenges, difficult working conditions and everyday complexities.  Patients are not aeroplanes, and hospitals are not production lines.

Most unfortunate part is the assumption that every sick person who dies in a hospital from an adverse event is an example of a truly preventable death rather than clinicians trying their best to keep someone alive and eventually failing.

  1.  Checklists and documentation to improve systems are wonderful in mechanical areas like operative care and inserting central lines, but have limited role and can only go so far without the most important virtues of being a doctor or nurse. It means more than mechanically following protocols and doing paper work in real sense.

In health care merely providing check list and doing extra- paper work may be counterproductive for many reasons.  Increase in time for voluminous documentations will consume time and forces health care workers to focus on paper work and takes them away from patient’s real issues.

Completed paper work and excessive documentation provides a false assurance of quality work, which may or may not reflect true picture of patient care. Even after full documentation,  still  it will be required  to be carried out in a diligent manner, a  task which is different from mechanical  task of mere check list  of other  industries . Learning from other industries seems to offer a simple shortcut to anyone trying to improve healthcare, but its utility is limited only for documentation purposes and not real quality. Caring for patients is radically different from flying aeroplanes. Healthcare is unique in the intimacy, complexity, and sensitivity of the services it provides as well as the trust, compassion, and empathy that underpin it.

Merely completing protocols mechanically and excessive documentation will result in decline in quality actually.  Simply importing and applying a ready-made tool will lead to situation, where quality will exist only on papers and merely  reduced to a number to the satisfaction of so called ‘pioneers’ of quality.

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?

NEET- Not so Neat- percentile system

 

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Comparison of AIIMS (medical) and IIT (Engineer) graduate with 5 years invested. Do doctors deserve better salaries?


       Let us compare the start of career for medical and engineering graduates. To have a balance, comparing apples to apples, comparison of AIIMS graduates (premier institute –medical) to IIT graduates (Premier institute -Engineering) looks justified.  This goes without any need to emphasize that students selected in both are exceptionally brilliant and toppers of the country.

    Although this comparison is not a secret and everyone knows about it, but still it need an attention from a different point of view. It should be an eye opener not only to medical students or aspiring doctors but to the society as well. It projects the severe disparity to an extent of blatant injustice towards medical students.

  When engineering students after a course of  4 years  (at 21 years of age )are placed with package of 1.2 to 3.6 crores (1-4 lakh dollars), the medical students are starting with internship. Medical students still need to study for at least 5 years more (at 21 years of age ) to start earning maximum 12 -15 lakh per annum ( 15 thousand dollars). It may be raised to 24-30 lakhs (30000 dollars) per annum after 10 years, still one tenth of their contemporaries from IIT. Remember we are talking about only premier institutes, what happens to others is still a matter of luck.

   When engineering students earn crores, do jobs and get experience about the real world, medical students are worrying about the problems, which should not have been there in the first place. The common issues bogging down the medical students are trying to get into post graduate courses, inhuman duties lasting 24-48 hours, payment of unjustified fee of medical colleges, trying to fend off bond policies, court cases, bearing with assault on doctors, working in poor and inept health care infrastructure- just to name a few.  With all these problems lingering for years, doctors remain unwise in worldly matters, financially illiterate and sitting ducks for punishments due to excessive regulation and unjustified moral burden.  

      This comparison is essential to be kept in mind by aspiring doctors when they choose medical career. The respect and money associated with the hard work to be a good doctor is no more available even to the best.


   A Point to  ponder for everyone, what is the reason for such disparity?  Why doctors do not deserve better salaries? What is the need for  aspiring doctors to choose lowly  paid jobs for more hard work and more noble work? A fodder for thought for society  and administrators as well.

IIT hiring: Domestic offer hits record Rs 1.8 crore

IIT hiring: Domestic offer hits record Rs 1.8 crore

MUMBAI: After a lull in the first pandemic year, crore-plus job packages returned with a bang on premier IIT campuses. On the opening day of the season, several IITians entered the crore-plus salary club, as the highest domestic package touched an all-time high of Rs 1.8 crore and international offers crossed the Rs 2 crore mark. While Uber picked one student each from at least five IITs, including IITBombay and Madras, for a package of Rs 2.05 crore (or $274,000), one student at IIT-Roorkee received an international offer of Rs 2.15 crore ($287,550) and three others got domestic offers ranging from Rs 1.30 crore to Rs 1.8 crore. In the first slot at IITB, the highest offer after Uber came from cloud data management company Rubrik, with a Rs 90.6 lakh (or $121,000) package.  Of the domestic roles, investment management firm Millennium picked students for a package of Rs 62 lakh in the first slot, while WorldQuant offered Rs 52.7 lakh and Blackstone Rs 46.6 lakh. IIT-Madras students get 176 offers in first session on day 1 ALSO READ IIT-BHU student bags Rs 2 crore package from US company in placement . The highest numbers of domestic offers were made by Google, Microsoft, Qualcomm, Boston Consulting Group (BCG), Airbus and Bain & Company. IT/software, core engineering and consulting were the leading sectors to hire from the institute in the first slot. As many as 11 international offers were made at IIT-Madras on day one, said professor CS Shankar Ram, adviser (training and placement), IIT Madras. The institute recorded 407 offers in the first session of the placements, its best ever, including 231 PPOs. In all, 11 students received offers that crossed Rs 1 crore and of them 10 got domestic offers and 13 students signed up for an international offer, of which 12 opted for packages less than Rs 1 crore to take up jobs in Japan and Singapore.

Record Rs 3.6cr offers to 3 from Delhi, Bombay, Madras IITs for Hong Kong posting

MUMBAI: Hong Kong and Singapore seems to be the destinations where IITians are heading to this placement season, with most big-ticket offers being offered by trading firms there. Jane Street, a quantitative trading firm, has picked at least one student each from IIT-Bombay, Delhi and Kanpur for its Hong Kong office for a record package of Rs 3.6 crore. These, however, were made as pre-placement offers (PPOs) before the season kicked off on December 1. Another high-frequency trading firm Quantbox Research has made an offer of Rs 1.6 crore at multiple IITs for its Singapore office. one IIT-Bombay student, there are other PPOs that have made offers to students of close to Rs 2 crore,” said a source at IIT-B. On-campus job offers have not touched the Rs 2 crore mark. “There are several Rs 1 crore job offers and there are 15 companies with international locations, On the first day of placements, IIT-Bombay had 46 companies interviewing candidates either online or in-person. Of the 250 job offers on Day 1, more than 175 were accepted. On Day 2, a total of 48 companies were at IIT-B. The highest package so far this year domestically is Rs 1.9 crore, while there are a good number of packages from international recruiters as well.

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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Assault on a Woman Doctor #Kerala: Medics Serving Uncivilized Society with Poor Law & Order


THIRUVANANTHAPURAM- Kerala: The assault on a woman doctor at Thiruvananthapuram Government Medical College has made doctors preparing for a career in the medical profession worried. A bystander kicked the woman doctor on her lower abdomen in front of an ICU in the middle of the night on November 23. The CCTV visuals showed that she was surrounded by a group of bystanders.

    The physical assault on a lady doctor reflects that doctors are serving an uncivilized society.  Such news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession.

     Strangely media, courts, prominent people, celebrities, human right commission, woman right activists and women commission are little concerned about the blatant injustice done towards doctors.  This again brings forth the hypocrisy of these people and organizations, who otherwise cry hoarse about woman rights and empowerment.  Whenever a female is assaulted, there is an outrage but the same support is not extended to a female if she is a doctor. Such bestiality should create havoc in minds of civilized people but this apathy to such incidents clearly indicates otherwise. Have we become so uncivilized that an incident such as this just remains as a small news item in a local paper? Can’t we see that such incidents are harbinger of many more in future? It is important to realize that this is the time to unify and condemn such episodes vehemently and prominently so that the miscreants realize that they cannot get away with it.

     Brutality against doctors reveals a deep prejudice and lawlessness, merely on the basis of perceived negligence. Government is either unwilling to act and establish a strong culture of deterrence, so justice been elusive for medical professionals.

Even murderous assaults on doctors are not enough to shake administrators, courts  and doctors’  organizations  out of slumber.  Definitely such violence, if unabated will be   poor advertisement for   next generation to take medical profession as a first choice.

Media and celebrities   have proudly  projected in films and television that doctors can be beaten and assaulted, in case there are unexpected results or in case of dissatisfaction. The “Reel Heroes” depicting violence against the doctor is seen as a routine and looked as an   easily do-able- adventure due to unwillingness of  Government  to take stringent action. As patients will continue to get treatment in hospitals and few cannot be saved, so every death declaration may be a harbinger to such attacks in future.

A notion has been propagated   that   assaulting a doctor under emotional  outburst  to be taken as normal and should not be punished.

THIRUVANANTHAPURAM: The assault on a woman doctor at Thiruvananthapuram Government Medical College has made doctors preparing for a career in the medical profession worried. A bystander kicked the woman doctor on her lower abdomen in front of an ICU in the middle of the night on November 23. The CCTV visuals showed that she was surrounded by a group of bystanders. She survived the attack and is recuperating. But the incident has left her shattered. “I am reconsidering my decision to become a neurosurgeon and even the career of a doctor,” she told Sulphi N, IMA state president, when he visited her in the hospital.The Kerala Medical Post Graduate Association has taken up her cause and demanded justice.

They are worried that such attacks would happen again and there would be a new victim. “It is unnerving that such attacks happen in medical colleges which are supposed to be a secure location. What will happen to us if we go to peripheral hospitals for practice,” said Dr Ruwise E A, Thiruvananthapuram unit president of Kerala Medical Post Graduate Association.He came to know from police officers that an arrest was unlikely on Friday and the accused was trying to secure bail. “The government should have arrested the culprit immediately and sent a message to the public that such attacks are not tolerated,” said Dr Ruwise.KMPGA plans to strengthen the strike if there is no arrest till Sunday. The doctors association has extended support to the protest by residents. “We cannot leave the students alone on this issue. It was an assault on a woman who was doing her duty. If it was a senior doctor who received such a kick on the lower abdomen he or she would not have survived the attack,” said Dr Nirmal Bhaskar, state president of Kerala Government Medical College Teachers Association (KGMCTA).The doctors share their angst as there was not enough support from government and society even when the attacks keep repeating. They did not take the Facebook post by Health Minister Veena George condemning the attack seriously.There are health experts who think that a multi-pronged approach is necessary to prevent such attacks. It involves reducing the crowd by strengthening peripheral hospitals, increasing staff and providing better security.“The government health system has become an easy target nowadays. Such attacks do not happen in private hospitals where bystanders pay the remaining hospital bills without uttering a word of protest even after the patient could not be rescued,” said Dr Althaf A, secretary of IMA, Thiruvananthapuram branch. He pointed out that there are no trained administrative cadres to manage a 4,000-bed MCH. All of this is managed by a superintendent who is also a professor with teaching responsibilities.

     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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Doctors’ Dilemma-To Follow Medical Science or Fulfill Medico-legal obligations (contract)


Medical Negligence case- Noida (death due to Covid -19)  is an example that should force the aspiring doctors needs to think whether they should put themselves in such a situation- akin to catching a falling knife.  A case which shows that in difficult situations, legal compulsions have potential to affect the treatment, without realizing what is good for the patient or actually required.  In difficult circumstances, while treating diseases with naturally poor prognosis, they can be still held responsible  for the situations  beyond their control. Doctors can be harassed for just being in a peculiar situation  and for being the only one  on the bedside of patient. Everyone wants some human factor to blame for the loss, which was at the best  God’s wish in real sense.

While  treating emergencies patients, there is  an eternal latent vulnerability that is intrinsic in the way doctors’ work, which turns more evil, just because of an unexpected poor outcome. Due to  misfortune of the patient, the  randomness of the tragic tale imposed on  the doctor becomes difficult to fathom.

No one can forget the dreadful times of Covid pandemic and the sacrifice of doctors. There was severe scarcity of beds, drugs, and even oxygen, a scary situation no one even imagined. There was  no one inside Covid ICU’s, none of the  relatives to support  their patients, except doctors and nurses.

     A patient who comes with 60 % saturation level of oxygen, but wants Remdesivir to be administered. His wish to get administered Remdesivir is taken as a legal contract between doctor and patient. Without  realizing that in such situations  administration of oxygen was   lifesaving but Remdesivir was not.  Doctors know the fact but patients are commonly misguided by the media reports.  Patients insisting upon Remdesivir,  that was not available. But could the doctor refer the patient to some other hospital with 60% saturation- especially in those uncertain times-taking that risk was not a feasible option. What would an average doctor have done? Only option was to  manage the  dangerous and precariously low oxygen levels. That is a standard medical teaching in critical situations. All drugs are of secondary importance. In this case, as proved by later studies – role of Remdesivir turned out to be doubtful, but oxygen was proved to be of real help.

    But patients precondition for admission was to get Remdesivir, a false belief generated more by media than scientific evidence. A false belief hence generated by media gave Remdesivir  the status of  a panacea and lot of money to the company, who sold it.

    But medicolegal compulsions  stamped the administration of Remdesivir as a contract between doctor and patient. A contract that needed to be fulfilled, akin to that of constructing a building. But it is actually different to treat critical human ailments from constructing a building. They cannot be treated merely by wish of the patient. Unfortunately, Remdesivir was not available and all the blame for death was conveniently loaded on the treating doctor.

  Doctors’ dilemma in present era is generated by conflicting solutions given by medicolegal implications and principles of medical science. Needless to say, doctors  will have adopt to defensive practice to save themselves from medico-legal harassments. For example in this case, doctor could have sent patient to some other hospital (in sick condition), according to patients’ wish for Remdesivir. But would that have been a right decision from medical point of view.  But legally it would have been safer for doctors.

 In other words- the blame -patient didn’t die of Covid-19 but because of lack of Remdesivir. What a sad conclusion for doctors? Non-availability of drugs is not doctors’fault.

   To save themselves from such medico-legal predicaments, aspiring doctors needs to think whether they should put themselves in such a situation akin to catching a falling knife.  

NOIDA: Five doctors of a private hospital have been booked under IPC Section 304A (causing death by negligence) in an FIR filed on the recommendation from the health department, whose preliminary inquiry found merit in allegations of a “delay” in administering remdesivir to a 22- year-old college student who died during the second wave of Covid last year. The management of Yatharth Hospital here rejected the charge, saying its doctors did their best to treat the patient, who was admitted in a critical state in April 2021. They also pointed to a remdesivir shortage at the time, and subsequent research that says the antiviral drug does not help in Covid treatment. A top-ranking official of the Indian Medical Association, meanwhile, stressed the need for a central law to safeguard doctors against such “violent action”. In cases of negligence against doctors, the health department has to verify allegations before a case is registered by police. In December 2021, Pradeep Sharma had told UP’s Pandemic Public Redressal Committee that his son Deepanshu (22) was not given the remdesivir injection on the first day of his admission to Yatharth Hospital in Sector 110 on April 30. This was despite the family having paid for the treatment, Sharma, a resident of Vijay Nagar in Ghaziabad, alleged. The committee forwarded the complaint to the health department in January 2022. “The preliminary inquiry has found negligence on part of the doctors as a delay was made in administering remdesivir injection to the patient,” the deputy CMO said in the inquiry report. Police said they would now be able to take up the case for investigation. The hospital administration defended its doctors and their line of treatment. “Deepanshu Sharma was brought to us with severe illness. His oxygen saturation was just around 60% and his lungs were affected. During Covid’s second wave, there were a lot of patients and the remdesivir injection was also not easily available. But we managed to arrange the injection for him in 2-3 days and administered it to him,” said Dr Kapil Tyagi, managing director of Yatharth Hospital. Deepanshu was admitted to the hospital for 35 days, after which his family shifted him to a private hospital in Delhi. He died at the facility in June. His father could not be reached for comment on Monday

     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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

An Epidemic of Substandard drugs, Fake drugs, Pseudoscience & Counting


    A frightening scenario is emerging as there seems to be an epidemic about fake or substandard medicines, spurious drugs and heightened belief in marketed therapies by advertisements.  An epidemic of ignorance that causes people to believe in pseudoscience or merely in projected promise of cure. A hope of miracle is flashed to patients, who have been given a ‘no hope’ by scientific medicine. Such patients are an easy prey for such fraudsters. It is not uncommon that lethal substances like steroids, hormones and heavy metals are given in dangerous doses.

       In the absence of strict Government control, all kinds of dubious assertions are available about curing all types of ailments.  These alleged remedies, and the belief systems they are based on, are based on the facts that can neither be proved nor disapproved. They are dangerous to life of patients, which is why it is necessary to fight them and refute them.  But who should fight? Patients themselves are blinded by a projected faith and false belief about definite cure.

Drugs samples- declared not of standard quality

New Delhi: In its latest drug safety alert, the apex drug regulatory body, Central Drugs Standard Control Organization (CDSCO) has flagged 50 medicine batches for failing to qualify for a random drug sample test for the month of October,2022.

These drugs samples which are declared not of standard quality include Levocetirizine tablets manufactured by Hindustan antibiotics, Onkam (ondansetron Oral solution) manufactured by Gujarat Pharmalab, Pantop-DSR (Pantoprazole Sodium Gastro-resistant & Domperidone Prolonged release Capsules IP) manufactured by Aristo pharmaceuticals, Diacowin-plus Capsules (prebiotic & probiotics capsules) manufactured by Zee Laboratories and others.

In addition, other popular drug sample that is declared not of standard quality include Montek LC (Montelukast Sodium & Levocetirizine Hydrochloride Tablets IP) manufactured by Sun pharma laboratories due to failure of Identification and assay of Montelukast.

Also Read:Drug Alert: CDSCO flags 45 formulations as not of standard quality

This came after analysis and tests conducted by the CDSCO, Drugs Control Department on 1280 samples. Out of these, 1230 samples were found to be of standard quality while 50 of them were declared as Not of Standard Quality (NSQ).

A few of the reasons why the drug samples tested failed were the failure of the assay, failure of the disintegration test, failure of the dissolution test, failure of sterility test, etc. The samples collected were tested in five laboratories, namely CDL Kolkata, CDTL Mumbai, RDTL Chandigarh, RDTL Guwahati, and CDTL Hyderabad.

Syndicate Supplying Fake Cancer drug Busted #Spurious-Medicine

The rise in “falsified and substandard medicines” has become a “public health emergency”. A surge in counterfeit and poor quality medicines means that thousands of patient  a year are thought to die after receiving shoddy or outright fake drugs intended to treat ailments. Most of the deaths are in countries where a high demand for drugs combines with poor surveillance, quality control and regulations to make it easy for criminal gangs and cartels to infiltrate the market.

More are thought to die from poor or counterfeit vaccines and antibiotics used to treat or prevent acute infections and diseases. Beyond the fakes that are made and sold by criminal gangs are poor-quality medicines that lack sufficient active ingredients to work properly, or fail to dissolve correctly when taken. Sloppy manufacturing is often to blame, but others are sold past their shelf life or have degraded in poor storage conditions.

There is an  urgent  need for  effort to combat a “pandemic of bad drugs” that is thought to kill hundreds of thousands of people globally every year.

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?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Blog at WordPress.com.

Up ↑

%d bloggers like this: