OPINIONS

Doctor, Heal Thyself!

Friday, June 1, 2012

by Dr S K Joshi

While watching the fourth episode of Satyamev Jayate, I was getting a feeling that Aamir Khan is touching a hornet’s nest. Sure enough. The protests started the same day. But it is not as I had expected. It is a much muted reaction from a few doctors, may be because the others are too busy in their practice. There have been some sane and mature voices also from some senior professionals who had the courage to accept the fact based criticism.

Dr Surinder Kumar Joshi

What Mr Khan had shown, discussed and brought to the public notice wasn’t anything new, not to the doctors at least. No doctor in India can claim to be so naive as not to know what’s happening out there. In fact, I would honestly admit that the presentation was very touching and stirring.

In film line Aamir has created new benchmarks of excellence not only as an actor, director and producer but also as a humanitarian thinker. Now he has entered the arena of social activism/reform. By taking on the evils affecting our medical profession head on and handling the issues with exemplary sensitivity he has done a commendable job.

Why the Protests?

The protests are mostly because:

1.      The criticism is coming from an outsider, a non-medical who himself is rolling in money.

2.      Medical profession is being singled out. What about other professions? Which profession is clean, politicians, bureaucrats, police, engineers, judiciary, lawyers, accountants… who is clean and not corrupt?

3.      Entire profession is being painted black because of some black sheep. A large majority are good doctors doing a good job considering the amount of workload they are handling.

4.      The poor salaries that the doctors are paid. Mr Khan should know the princely salary (about Rs 20000/-) that an average doctor draws in India after getting his degree and even after PG (Rs 30 to 40 thousand). Impressive returns after investing 10 years of their life and almost a crore of their hard earned (or borrowed) money on their MBBS degree and further more on post-graduation!

5.      The adverse conditions under which the doctors have to work, in terms of lack of equipment, trained manpower, and poor facilities.

These are some of the points they feel that Mr Aamir should have taken cognizance of. Although some of the grievances of doctors are well justified, they cannot serve as an effective defence against the charges.

Their objection to singling out the medical profession, for instance, has no validity. This is the only profession, which affects the human lives so critically and so directly. No other profession can have such crucial impact on human lives as the medical profession. And therefore, any dereliction, negligence, carelessness or corruption gets magnified a hundred times instantaneously. Aamir has taken up the subject because corruption and unprofessionalism in medical profession has reached such proportions that it is seriously affecting the lives and safety of people.

There is no denying that medical profession has been doing a great job for relieving the pain and suffering of mankind for centuries and the society has generously appreciated that by elevating the doctor to the level of demigod. But unfortunately the creed of those devoted and honest doctors is gradually dwindling so much that they are in danger of becoming an extinct species. The number of cases of corruption, carelessness, negligence and even criminal offences among medical professionals, in the present day, is alarming and they are on the increase. Every day we hear the news of doctors arrested in some or the other place for some or the other offence. The problem is further increasing because other doctors (who are clean) do not do their duty of reporting these corrupt doctors to the Medical Councils as required vide MCI Regulations 2002.

Traditionally, medical profession has been allowed to self regulate. But now because of the irresponsible (even criminal) behaviour of many unscrupulous and greedy doctors, and non-effectiveness of the Medical Councils in regulating their conduct, the society is feeling increasingly restless. They do not trust the doctors any more as much as they did in the past. But the genesis of this malady needs to be understood in the correct perspective.

Health — a Low Priority: The problem starts with the political system. Health Ministry has generally been among the lowest priority in terms of the budget allocation as well as the appointment of health ministers. Most of the health ministers have been the individuals who had no clue about the subject of Health Planning and Administration. Many of the appointees are such as have already proved their incompetence elsewhere or those who have to be adjusted under pressure from Mamtas, Lalitas, Mayas or other coalition partners. They neither have the acumen nor any interest in the job. The MCI and its State Councils have been a big disappointment, ruining whatever reputation the profession had. Still, it is not that there is a dearth of competent and honest doctors in the country. The problem is that our system does not want them.

Quality of Medical Education: As regards the doctors, there is certainly a decline in the quality of medical education. The young boys and girls who enter the profession are still innocent, honest and untouched by corruption. They can be moulded any way. But our worthy teachers do not have the time from their private practice or other activities. The example most of them set (to be emulated by the students) falls far short of the image of a teacher in terms of honesty, integrity, commitment and concern for teaching for which they are hired and paid. The tradition of administration of Hippocratic Oath to students in medical colleges is no more in practice. The Code of Professional Ethics and Conduct prescribed by the MCI is not known to an overwhelming majority of the fresh graduates because medical ethics is not a subject included in the curriculum. The only time the subject crops up is when the doctor has to apply for registration with the State Medical Council which requires the doctor to submit an affidavit that he has read the MCI (Code of Conduct, Ethics and Etiquette) Regulations, 2002, doesn’t matter whether he has actually read it or not.

Quality of doctors also depends on the quality of students entering the profession. Mr Aamir mentioned that most of the students entering the medical profession must be very intelligent. Well, one cannot be too sure — certainly not about the students who get the admission after paying huge capitation fees and enter the medical colleges licensed through bribes. Many of these students belong to very rich families and all they are interested in is getting a degree to decorate their names rather than learning the profession. Why are so many young dentists and medical graduates running after MBA these days rather than practicing their profession and honing their skills? The fact is that many of them did poorly because of poor training facilities in the colleges or due to lack of aptitude and find themselves a ‘misfit’ as a clinician. The same seats could have been utilized by students who were really interested in the profession. These are some of the factors affecting the quality of students entering the profession. If some of them still remain dedicated even after graduation, the conduct of senior professionals under whom they work, serves as a good detergent to wash off the stain.

Money Matters: Let’s look at the problem from economic angle. The society and the government expects that after having invested so many years and so much of money, the doctor should remain satisfied and happy and work like a ‘good boy’ (or ‘good girl’) in rural areas without adequate facilities/amenities and continue working like a dedicated robot without any care for his own and his family’s needs, necessities and aspirations. When people around him from ‘Mantri’ to ‘Santri’ are blatantly eating into the portals of the nation, a doctor must have a Teflon coating to keep him protected from the evils afflicting our entire society. Let’s not forget that the doctors, too, are from, and live in, the same society. If the society around them has become corrupt and is getting away with it, how can the doctors remain unaffected?

I am an optimist and do believe that the malady is not incurable. The solution will come up once the doctors seriously get down to diagnosing the ailment. They will find the cure also. Starting with working for a less corrupt society we also start indoctrinating the next generation doctors who are still free from the germs of this malady. As far as the senior doctors are concerned they are as much open to scrutiny by the IT department as any other citizen of the country. But the first step would be to put the corrupt politicians on the mat (Who will bell the cat!). Once that is started and implemented in the police and IT departments, doctors will automatically fall in line. They are, by and large, amenable to reasoning because a large majority of them are good professionals not yet corrupted, but forced to compromise, may be to avoid being odd men.

Going by the news of doctors being caught/arrested for various acts of omission or commission every day, it does appear to be a case of ‘Res Ipsa loquitur’ (Latin for “the thing speaks for itself”). The explaining has to be done by the medical profession and not by Mr Aamir Khan who is only showing us the mirror. He is only helping us medicos heal our ailing system. My medical brethren will do well to do some honest introspection. It’s time to clean up the house rather than shooting the messenger.

Dr S K Joshi
MBBS, MD (HA), DNB, QMAHO, MIPHA, MAHA
Hospital Administrator, Assessor for NABH Accreditation
Visiting Faculty: PG Courses for Hospital/Health Management / Quality Management
Author:
‘Quality Management in Hospitals’
‘Law and The Practice of Medicine’
‘Safety Management in Hospitals’

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34 Comments »

Comment by gurudev
2012-06-01 11:49:26

As was rightly pointed out in this episode of Satyamev jayate, a large number of private medical colleges have mushroomed all over the country. These are centres for fleecing students and bribing the MCI to certify them as up to the mark. Most of these enjoy political patronage also . They are producing highly incompetent doctors as they are hardly exposed to large number of patients.
The government is least interested in rural healthcare. All new medical colleges should be set up in remote rural areas. This would help in improvement of rural healthcare. Instead, the government wants to go on adding new medical colleges to competently functioning hospitals in big cities like Delhi.

 
Comment by Maj Gen Bikash Mohanti.
2012-06-01 12:30:17

Bravo,SK…Well said…Unfortunately the black : white ratio is 80:20. A perfect health care can only come when we reverse the above ratio…
My compliments to you for your forthright views as always..

 
Comment by Dr Rashid
2012-06-01 14:28:41

I t is time medical professionals introspect rather than attack the messenger.

 
Comment by AK Sinha
2012-06-01 14:41:32

Request two things :
1.All politicians & Beurocrates to get treatment at Govt. Hospitals.
2.All educations for the above mentioned catagory in Govt. Schools/ Colleges/ Institutions.

 
Comment by Dr. Anil Kumar
2012-06-01 17:59:49

I will treat my 50% patients free of charge if I get in a year just 50% of the amount earned by Amir Khan by just one feature film.

Dr. Anil Kumar
MBBS, D.Ortho, DNB-Ortho

 
Comment by Dr. Ramesh Vardhan
2012-06-01 20:21:48

hats off to dr .joshi , mind blowing article , to be sent for a award , total command over the language (unlike me , most often seeking help from my wife ) , well , once a soldier always soldier , people like you should take over the command to motivate the budding doctors ( as well their greedy parents ) . about hard work , honesty , care , concern , etc. even it more important to guide idiotic patients who go after big names \ so called corporate hospitals , with out judging the capabilities of a doctors . there are n number of touts \ agents \ middle man in & around railway station \ bus stand \ govt. hospitals . the place where ( bidar medical college ), right in front of hospital , there are plenty of tiny ambulances to steel the patients around the clock . the govt. spends rs 40 \ kms to bring a patient free of the hospital ( say around 500 to 1000 rupees ) .soon after same patient is shifted to near by nursing home run by the one . or the other . i have a strong feel there a nexus between hospital staff , pvt.hospitals , labs\ scanning centres . even govt. hospitals should charge money , and give some benefit to the treating doctors.( clinicians ) .the funniest \ stupid thing about the medical colleges they give same salary both for clinical staff & non clinical . there are few surgeries, procedures , literally drains you out . you may not believe, there is no( potable water in operation theatre leave alone tea or a cokes . my professors used to get us break fast with patient ‘s money( on the o t day) . i remember at times i used carry break fast from home to other friend too. luckily there were couple of canteens with subsidised rates , where we could eat enough food with less prise ( thanks those canteen owners). but here i can’t even look for a cup of tea , because there is no canteen . with > 40 temp. i left with signs of dehydration . as per mci we are suppose to have so many things ‘, in reality you see people pissing \ shitting all around hospital with out any fear . i wish mr. amir khan also bring out these things in his episode . satya meva jaiyathe. this serial should be really a truth full story ( mr. khan go after pvt.colleges \ mci \ corporate hospitals even after some the govt.hospitals you will occupied for rest of life & oscar is assured). dr.ramesh vardhan

 
Comment by dr kanak shah
2012-06-01 21:36:10

i am ready to serve all my pts free of charge ,, if i get amount which was spent for publicity of 3 idiots..

 
Comment by dr kanak shah
2012-06-01 21:41:13

even if we agree to this ratio.. .can we point out why this happen…to my best of thinking.
when society started respecting money in stead of knowledge , doctor started feeling of getting in main stream of society,,,, by collecting money by any means,, ofcourse this is not justified but at the same time,, ,you can not neglect changing value of society.

 
Comment by dr kanak shah
2012-06-01 21:44:04

he wont because all these things are with blessings from politicians.

 
Comment by Dr T K Bhattacharjee
2012-06-01 23:51:51

Very well analysed and said by Dr Joshi. My regard to you sir, as I saw some one is truthfully accepted and presented the fact.

 
Comment by Dr K.Gowrinath
2012-06-02 06:48:37

The whole problem starts when the public thinks that doctors should have service mind and human touch.But are doctors who work as per expectations of public are recognised ?.In any place, doctor who has more patients and more money get honours.Please note that many doctors are forced to follow their corrupt friends to earn money by any means just to get name and fame by their own family members.How many state government doctors are able to work at the same place without bribing the executive or politicians?. Many doctors feel that service without recognition is a punishment. Unless doctor has enough money and ways to get patients through any means,you will live in penury. The private medical colleges provide ideal platform for those who have money and support. The medical faculty are pressurized by the private medical college managements on many occasions to pass the students who paid them well irrespective of their performance in the examinations. The quality of medical education was naturally diluted when the number of students per professor was increased and the number of beds required in a medical college was reduced by the board of governors appointed by the central health minister both for undergraduate and postgraduate medical education.The medical research is never recognised in most of the medical institutes and doctor won’t get even an extra annual increment so many of them spend time more on ways to attract more patients.Why postgraduate medical courses are allowed in a department having faculty without any research background?. In many instances, the postgraduate medical students are guided by the professor who does not do anything better than a private medical practitioner and substandard content of dissertation work is the obvious result. Those who are not teaching medical faculty will be shocked to know the daily allowance of a professor paid by the Maharashra government for conducting MD/MS examinations even today. It is less than Rs 200/- and yet to be revised. How can a professor get accomodation and have food with that money in any city is for everybody’s guess. Not long ago,there were few medical colleges and intake was only 100 students per year and there was opportunity learn well.When public is attracted by the looks of a medical establishment rather than the qualification and skills of a doctor, more and more corrupt ways emerge to earn more money in medical profession.The Medical Council of India was only a symbol of corrupt political system.The so called sathyameva jayate programme should have focussed on the issue of why doctors were dedicated in the past and not so now?. The attitude of government and the public are also responsible for increasing corruption in medical profession now. Please discuss the issue of corruption from its origin and not the process.

 
Comment by subodh kumar singh
2012-06-02 07:46:42

The episode by Amir Khan (who is neither a social activist nor a reformer, but only an actor,producer,director and works with only one motive- earn money and publicity by presenting something which audience would like. And he masters this art.), article about it and many comments ,only generalize the things. Medical profession as whole (now I generalize it) in India is passing through a difficult phase largely due to long standing neglect,greed ,corruption,political intervention and interest,bureaucratic high handedness and idiotic decisions,populist policies by the government,bashing by the media,politicians,bureaucrats ,public,exploitation by all of them and corporates. They have loosed position of the cream of the society—they neither have respect nor money ( today you get respect either by position,power, money or possessions and rarely by your work and contribution to the society ). I am not going to repeat how difficult it is today to become a specialist doctor. For all the above the government, policy makers, bureaucrats, media, and public is responsible and not the doctors.
Why was there a surge of starting so many private medical collages when government could easily increase the number of seats in government colleges and open new colleges. At that time they said that there is a huge gap in the number of doctors that we require and that we produce and we do not have sufficient money to start new medical colleges and we cant afford to provide subsidized education…… They had loose control on the colleges and most of the colleges belonged to politicans…
But even if you compare the quality of education and doctors produced by the colleges,— most private colleges make efforts and have regular classes and are of good standards. Most government colleges are very poorly managed and teach very poorly. Most of them will be de-recognised if MCI became strict.

Even if we consider that half of the seats in most private colleges are filled by financial reservations, the same happens in government colleges— half of the seats are by cast quota and many by bungling the exams and corruption. Many of them become teachers further reducing the quality— their students become teachers— reserved casts by preference. So the quality is destined to be doomed- and doctors are not responsible for it.

The corporate hospitals and medical insurance are responsible for steep hike in the treatment cost and unnecessary procedures. Corporates will kick out the doctors who are not generating enough revenue.
Government policies, media, public expectations and rude behavior and rage is making it difficult for individual doctors to start their own small set-ups and run a decent honest practice. They are forced to work for people who have invested money to start a hospital for the sole purpose of earning money.
Health is considered an industry today and we ( ministers, bureaurocrats and corporates ) very proudly say that is growing fast. What do you expect from an industry? service!!!
You are strangling all right thinking doctors and preventing all right thinking students to come to this profession and yet criticizing them and a group. If India continued in the same way, very soon it will kill this noble profession.

 
Comment by Dr. Ramesh Vardhan
2012-06-02 18:02:59

one should thank , dr. joshi, dr.gowrinath , dr.subodh & other for providing the real pictures. in fact like minded people should form form like team anna. for public awareness . to provide facts & figures about health care related events\ activities . we can provide list of doctors , hospitals, medical colleges . we can give them seeding \ rating . by creating our own team of inspectors ( parallel to mci ) with the help of i m a or other specialist bodies. we can manage the show much better than mci , who’s inspection a mere mockery with flying visit. this way we can provide true picture at a minimal cost. the local doctors know the true stories of hospitals \ medical colleges. unfortunately we don’t have a platform to share our views . we should be thankful to aala times for providing site to express our views with out any censorship. dr.ramesh vardhan

 
Comment by S K Khatri
2012-06-04 15:39:53

I thought you would be intelligent enough being a doctor, but you failed me to think and be sure of.

The reason: your comment. I would have expected a legit rationale rather than such stupid interest of yours.

Basically, you seem to be from that herd of black sheep that only care about the money. Only once you are well fed with the money, you would go out and do the good in the community.

JUST THINK.. that between the monetary demands and extortion of the doctors and the corrupt political gang, its the common man who is paying the ultimate price.. the rich have enough to get treated overseas or in those 5 star Hospitals, its the poor that see their loved ones dying out there because of all what Aamir highlighted. And what if he’s earning well, at least he’s not cheating anyone..

 
Comment by S K Khatri
2012-06-04 15:44:51

Last comment In response to —————————- – - – -Dr. Anil Kumar
MBBS, D.Ortho, DNB-Ortho

 
Comment by Tom
2012-06-04 15:46:30

Dear Doctors,

The profession you chose is for the safety of man kind rather than it should be a business for making huge profits. As once the unknown person said the doctors are considered next to God Brahma because Brahma is the Creator while the Doctor is a Curator and nurturer (he who one eliminates the Diseases and cures the patient and gives him extra years to live).

I think the Doctor should not be much greedy towards the Money at the stake of other People’s life. As mentioned by the Doctor Devi Shetty (Founder on Narayana Hrudayalaya) you people will also be given salaries and enjoy good life.

 
Comment by Ghansham Ojha
2012-06-04 15:59:34

Dear All,

Namaskar!

Shri.Dr.Surinder Kumar Joshiji, said the truth of current situation in our greater INDIA about Doctor’s! I am with the words of Dr.Joshiji and I wish citizens of INDIA should know about such grave issues and act wise. For the sake of few corrupt and culprits minded people saying, we cannot raise the fingers on honest and sincere people services. It is also bitter nicked truth that HOSPITALS becomes HOTELS in Greater INDIA! Pay and get the treatment and most of the doctors are making business with the needs of needy citizens Ex: Unnecessary C-T Scan, MRI Scanning, Blood Testings, X-Ray Report etc.,

It’s time to draw our personal attention on HEALTH CARE and I am sure Government of INDIA will immediately focus on such important issues and do needful in the matter.

May GOD give sense to all section of people to know the importance of DOCTOR and their services.

NOTE: Your faith is your remedy! Keep faith in sincere people forever.

e-MAIL: anticorruptionteam@india.com / iyso.ceo@gmail.com

MAY I HELP YOU: 09885491221 / 09000077755.

JAI BHARATH…

With Attention:
Ghansham Ojha,
F&P IYSO Team INDIA,
P.D: YOUNG INDIA MISSION,
P.D: ANTI-CORRUPTION TEAM INDIA,
KARIMNAGAR-(A.P), INDIA.

 
Comment by Aboli Deshpande
2012-06-04 16:05:47

Good article sir! many who commented seem to be doctors, who said that people in this profession know what is going on and that it is common knowledge. I am not from this profession and i would like to bring to everyone’s notice that nor are 70% people in this country. the general public does not know what was brought to our notice in the show. this show is not only for a selected few. Also about maligning the image of doctors: i have been going to my Family doctor, dentist since i was young, i have seen that they have never given any opinions which may harm us, so we will not instantly think of them also as part of the negativity in the profession. But we now know hat such bad doctors also exist and we need to be careful. I feel that is the basic purpose of the serial which they have achieved. And it dosen’t matter how much Aamir earns he will earn it whether it is this serial or some movie or any reality show. Atleast this spreads awareness.

 
Comment by Rajeev Nayan Ghuwalewala
2012-06-04 16:17:31

It’s wrong to say that there are few black sheep due to whom image of the entire profession is tarnishing. The bitter truth has been that there are very few who don’t accept direct or indirect favours from specialists, Pathologies, diagnostic centers, Nursing Homes and Drug manufacturers. Justifying their wrong doings by comparing remunerations and work conditions with other professions or business is not fair. If other professions or businesses are more rewarding than one should have opted for that profession or business instead of medical profession.

Last but not the least there is no justification in looking at how much money Aamir is making. The discussion should be confined to the issue raised in the program which is concerned with the common men.

 
Comment by mamatha
2012-06-04 16:25:30

There was one comment made by Aamir in the show which answers a lot of questions being posed here again concerning money. A person who could get on into this profession is surely enough intelligent. So, if it is only for earning money why enter a sensitive field like medicine, let them choose some other profession. we are sure India has enough areas that are corrupted and profitable. Why earn profits at the cost of human lives?

 
Comment by mano nabial
2012-06-04 19:16:51

guys i just happend to b one of the patient who being treated by one of u everytime i got ill. .nd like we have our favourate teacher we hav our fav doctors who treated us right , not only cure but heal too . . i still remember sme 6 years back when i had sme kind of infaction right between ma eyes nd nose.( had a swalling which nt allowd ma eyes another eye to open) . i went to nearest private clinic nd to other 3. . ma bad.,but realy soon i sensed in they had no clue what it was nd talking like a busines man who has opend a shop only to earn.. (earning is good but how u earn is smeting to b thought off) nd not even understing the pain i was going through . .i left d hope that they can treat me right. . then i went to Safderjung hospital delhi, met a real doctor nd in between d convertation i just wished every doctor to b like him . . Ther was other patients a long cue outside but looking at ma fàce they let me in Doctor – i dont realy consider it as a profession but a selfless service . .nd thinks

 
Comment by Yugesh
2012-06-04 19:40:14

Dr Shah,

Please do understand the matter at hand. Aamir is not asking you to charge your patients less.Please do not put aside your personal luxury for social service’s sake.All Aamir and we the people of India are asking of you and your band of brothers is not to overcharge your patients and not take cuts from other doctors to refer patients who would in return charge your patients more for the cut they pay you.You are after all a healer and the society needs you.Your services are valued greatly and we salute you for that.

Satyameva Jayate.
Jai Hind.

 
Comment by Alok
2012-06-04 20:58:08

Dr, Anil Kumar,

R u blinded by money. Grow up man. Ask a common man (not from doctor’s fraternity), whatever shown in this episode of Satyamev Jayate and written by Dr S K Jpshi is 100% true.

This profession needs healing. A lot of people has suffered because of this. Close your eyes and think with an open mind and heart about the last few days of experiences of which ever hospital you work for , you will get the right answer.

 
Comment by Rajneesh
2012-06-05 08:41:58

Dr. Anil, i am not sure whether should i call you doctor or not. the present scenario is due to the kind of yours professionals. you are talking about money and comparing it with amir khan, after all he is just a entertainer as he said many times before.
Tell me one thing who are you? and why did you choose medical profession?? only to make money even on the ground of people’s lives. Lawyers make money, engineers practice bribes and many of others are in corrupt skin but all of them don’t affects the human lives so critically and so directly. No other profession can have such crucial impact on human lives as the medical profession.
Now think over what you said and put yourself in appropriate shoes. You should be DOCTOR not a SUPAARI KILLER.

 
Comment by Rajneesh
2012-06-05 08:49:21

Ms kanak shah i’d advise you to leave medico profession and do some business rather taking lives for money.
I know i am not doing it right and please pardon my language, if your kind of persons will get paid high amount then you will sell yourselves too.
Please don’t embarrass your profession.

 
Comment by Munmun
2012-06-05 20:20:29

Dr. Anil… Y b a doc then… U share ur name with industry’s top-notch actor… u wanna earn, go join him thr n quit what u do now coz it’s the money that calls u not the profession.. So how does it matter anyways that u earn being a doc or an actor…

 
Comment by Jassim
2012-06-06 13:14:26

Its surprising how most of the people here (medical professionals i presume) like to aim their guns on aamir khan, we all know that he is rich and is raising these issues perhaps for professional reasons and not on a moral highground…..

Now since we have got that out of the way….

Can we (I’m a non medical professional and a recent customer of a hospital and nearly a victim) stop pretending that everything is fine ?

The fact of the matter is that healthcare is an industry which requires money and profits and doctors are professionals who need to be compensated…..

Having said that, real lives are being dealt with here and we need effective checks and balances in the system to reward good practices and punish the bad ones…

Eg, if a doctor messes up on a surgical procedure, the victims have every right to take this to a court and sue…but not to bring a crowd and thrash the doctor and destroy the hospital….at the same time the medico legal system in the country should also be reliable enough..else you can see the gangajal practice of vigilante justice being meted out to doctors as well…

Eg, medical insurance should be made compulsory

Blah Blah….

Seriously, should we all even care ?

Next week, Aamir Khan’s off to the next hot topic, like child abuse or men getting groped on public transport etc and docs (atleast some of them) are back to saving the world…like we see on firang TV shows….

 
Comment by Bunty
2012-06-06 18:04:53

Found this interesting piece of information about the transplant case that was so hyped about at SatyaMevJayate:
Please read and forward, this can happen to all of us.

Dr.Sreedhara

My e-mail to Aamir Khan is noted below:
==========================
Respected Aamir Khan Ji

I watched with shock and despair the Satyamev Jayate program of May 27, 2012. I am responding since you referred to me although you do not know me. I am the Nephrologist that you referred to while conversing with Mr. Rai. Mr. Rai has been making false and fabricated allegations for the past 2 years. While talking to you, in addition to providing you with false information, he also withheld crucial facts.Over the past 2 years, Mr. Rai has been harassing the Transplant surgeon and myself (Nephrologist) and the Hospital by filing multiple and concurrent complaints at various fora whether or not they have any role on his complaints. With his manipulations, he has succeeded to a great extent in bringing to a standstill transplant surgeries at the the Hospital which has caused a great deal of hardship to several patients. In addition, he has also caused immense damage to the noble field of cadaver transplantation in Karnataka State.Once you are aware of the actual facts, I have no doubt that you will express regret for having given platform to a sophisticated lier with immense theatrical and manipulative skills.Here are some facts that shed light on the truth.

1. Mr. Rai never informed you that Mrs. Seema Rai underwent cadaver donor transplantation and was registered for a cadaver transplantation more than one year prior to surgery. The phone call on the night of admission was made because a suitable cadaver donor had been identified by ZCCK (Government body that allocates cadaver organs) and not by the doctors or the Hospital. Cadaver transplantation has to be done emergently, otherwise the organ(s) will decay within hours and become useless. That is why the patient was admitted on Saturday night (1 May 2010). The patient and her family were all informed about risks and benefits of transplantation for more than 2 years (since June 2008). In fact, whenever the patient consulted me she was eager to get kidney transplant so that she could stop the misery of undergoing dialysis. You can ask any dialysis patient, they will inform that they do not want dialysis but prefer transplantation.

2. Mr. Rai, Mrs. Rai and Abha Rai all were again counseled for more than 1 hour on the night of admission about kidney and pancreas transplantation. Subsequently they also discussed with their relative in New York. Then on the night of 1 May itself Mr. Rai personally informed me and other doctors to proceed with kidney + pancreas transplantation. The Informed Consent form was signed on the night of 1 May itself and handed over the ward doctor. These facts have been documented by the nurse as well as the ward resident doctor. The State Medical Council as well as the National Law School of India have investigated the Informed Consent issue and clearly stated that Informed Consent was indeed taken prior to surgery. In fact, if the Informed Consent was not given on the night of 1 May, the cadaver organ would have been allocated to the next patient on the waiting list for cadaver transplantation who was also admitted to another Hospital on the same night for possible transplant surgery. (Whenever a cadaver donor is available, several patients on the waiting list such as Seema Rai are called and advised to get admitted so that the cadaver organ does not get wasted in case one or more patients are found to be unfit or do not want surgery.) If Mrs. Rai and her family had not consented for the surgery on the night of 1 May, then a surgeon from another Hospital would have proceeded to retrieve the cadaver organ on the night of 1 May. The surgeon from our hospital would have gone home. The very fact that our surgeon traveled on the midnight hours of Saturday to the donor Hospital and brought back the cadaver organs by about 5.30 AM on a Sunday morning suggests that the patient and family indeed had agreed for the surgery.

3. Mr. Rai also concealed from you the fact that he had telephoned the Nephrologist several times on the night of 1 May to seek help to arrange for a special medicine (Simulect) that was to be given to the patient in the Operating Theater before the transplant procedure. The Nephrologist had personally called the Pharmaceutical company on Saturday night to help Mr. Rai to procure the medicine. The Nephrologist had given personal surety to the Company since Mr. Rai told him that he did not have cash to purchase the medicine in the middle of the night. In fact, Mr. Rai procured the medicine at about 7.30 AM on 2 May (Sunday) and handed the same to the Operating theater staff. If the patient and Mr. Rai had not consented for the surgery, why would he purchase the medicine and hand it over to the Hospital staff?

3. Mr. Rai never asked the doctors or any other Hospital staff not to proceed with the surgery at any time. He was plainly lying when he made a statement to that effect to you. If in fact, the patient and her family had not consented for the surgery, that would have been Mr. Rai’s first and major complaint when he filed an FIR with the police on 30 May 2010 accusing the doctors of murder. In his initial complaint to the police as well as to the State Medical Council, Mr. Rai never complained that he or the patient had not consented for the surgery. This fabricated allegation is clearly an afterthought on Mr. Rai’s part.
4. The patient did not receive 119 units of blood, i.e., 60 liters of blood. She received 33 units of blood over 4 days which is about 13 liters of blood since she had developed a massive bleeding condition called Disseminated Intravascular Coagulation (DIC). She also received platelets, FFP and other blood products to correct DIC. The doctors never told Mr. Rai and his family that 390 cc of blood would be required. No doctor can predict the exact amount of blood loss in a given patient who undergoes surgery. Besides, the large requirement of blood in this patient was due to the fact she developed a medical complication called DIC which can happen after any major surgery or major trauma. Normally in transplant surgeries, we do not transfuse any blood at all.

5. The transplant surgeon is highly qualified to conduct pancreatic transplantation as well as kidney transplantation. He is trained at well known Hospitals in the United States where he had conducted numerous multi-organ transplantation surgeries. All relevant documents were reviewed by the Health Department before the Hospital was granted registration for multi-organ transplant surgeries in March 2010.

6. Mr. Rai was again lying when he stated that the doctors had switched off their phone on 6 May after the patient’s death. In fact, Mr. Rai spoke to the doctors several times after the patient’s death. This can be easily verified by looking at Mr. Rai’s phone records.

7. The Hospital was registered for multi-organ transplantation. There was a clerical error in the Certificate which was acknowledged by the Health Department. The Health Department have clearly stated in their report that registration for liver includes pancreas as well (since the skill required for transplantation of both these organs is one and the same).

8. Mr. Rai also withheld from you that the Karnataka Medical Council has thoroughly investigated the case and found no evidence of any negligence on the part of the doctors.

9. Mr. Rai also withheld the fact the Hospital bill was not for the surgery alone. Most of the cost was due the use of blood and blood products and other medicines which was necessitated by the development of DIC and infection. If the patient had not developed DIC, the bill for a transplant surgery would have been about Rs. 3.5 lakhs. In fact, there was no additional charge for pancreas at all. Whether the patient received cadaver kidney or cadaver kidney + pancreas, the bill would have been the same. There was absolutely no financial motive in recommending the combined surgery. The surgeon recommended combined surgery because diabetic kidney failure patients do much better with combined cadaver kidney + pancreas surgery than cadaver kidney transplant alone. This has been well established in the medical literature. The surgeon made the recommendation with the best interest of the patient in mind. Even todate Mr. Rai has not produced any scientific evidence or professional opinion to contradict the recommendation of the transplant surgeon. All transplant specialists who have reviewed the case (from AIIMS-New Delhi, PGI-Chandigarh, Chennai, Bangalore, and USA) have unanimously opined that the patient received the best possible treatment and that her death, although very unfortunate, was not due to any negligence on the part of the doctors or the Hospital.

10. Mr. Rai also did not inform you on the Air that he has filed a complaint with the Consumer Forum seeking compensation of Rs. 84,55,933/-. I am sure Mr. Rai has used his theatrical skills to convince you and your team about his false allegations. I am also confident that you will realize the lapse your research team has done once all the facts become apparent. I am enclosing a detailed Medical History as well and other documents that shed light on true facts.After my medical college, I studied and then worked in the United States for nearly 16 years. I came back with a dream to serve my countrymen. However, now after going through the mental trauma caused by a reckless individual who is inadvertently abetted by a corrupt officialdom and a thoughtless media, I am beginning to wonder if I made a mistake in returning to India. Perhaps, I should also go back to the United States like the doctor that you showed in the opening sequence of your program who returned to the UK because of the corrupt system in India.

I invite you and your team to visit the Hospital, meet other patients who have undergone/undergoing dialysis, patients who have had transplant surgery, and meet the Transplant surgeon so that you can clarify all the facts for yourself.Please do not hesitate to contact me if you need any clarifications.

-Dr. R. Sreedhara
+91-98801-50813

 
Comment by Bunty
2012-06-06 18:17:16

DOCTORS VS AAMIR KHAN
Letter no.3

A letter to an
Ignorant Perfectionist

Dear Mr.Aamir Khan,

I have been trying
hard but cannot get over the fact that you can ‘sell’
ignorance with such ease
and honour.

Though I agree to ‘parts’ of your show ,

Lets
first get the facts right.

1) You said patients
on dialysis live upto 15-20 years. Fact – The 5 year
survival rate of patients
on dialysis is about 25-30 % ( less than many
cancers). Renal transplant
remains the best available treatment option for chronic kidney disease. (I hope
you take responsibility for people who after
watching your show plan to not go
for kidney transplant and die in less than 5 years)

2) An
overenthusiastic girl from the audience said that
her father was forced for an
emergency liver transplant ’6-7 years’ ago for
gastroenteritis.
Fact- Even
today there are ‘ a handful’ of hospitals in India offering liver transplants.
To think that 6-7 years ago , just a gastroenteritis
patient was offered liver
transplant is not only improbable but technically
impossible.

3) A diabetic patient
blamed a doctor for losing a toe.
Fact- Lacs of
diabetic patients per year lose
entire limbs due to diabetic foot ( cellulitis and
gangrene) . Doctors go about
stepwise cutting off toes , then foot , even the leg upto above knee level in
order to save as much limb as possible. The patient
in your show might still be
able to walk just because of the timely action taken
by the surgeon.

Mr. Aamir Khan i am
not getting back at you because i took your show
personally. Yes , I agree that
there are doctors indulging in shameful
malpractices and even i know a few of
them. But i can proudly say i am surrounded by more doctors who work day and
night just to ensure that their patients get the best
possible treatment..The’
BAD’ doctors should be punished and we all can
come together to ensure we do
not encourage such malpractices.

Secondly i would have
appreciated if you would have thrown some light
on the entrance examinations and
the hard work , dedication and sacrifices a doctor
needs to clear his MBBS, MD,
DM etc examinations. I wish you had spent half a day in the
emergency department and OPD of a Govt. Hospital
and realised that the work
timings, working conditions, lunch breaks,
doctor : patient ratio, hours of
sleep per week , living conditions in the hostel and the stipend is worse than
a class 4 labourer. You would have also
surprisingly realised that the
‘DOCTORS’ are the only ‘FUNCTIONAL’ part of a Govt.
Hospital which still caters
to thousands of patients in a day. When you compared statistics of U.K and
India , why didnt you include the salaries, living
standards and the doctor:
patient ratio the doctors have in developed
countries.

Coming to generic
drugs, Yes, a large amount of rural population
should have access to cheap
generic drugs. But one should not forget the
pharma companies that charge more
for the drugs are the ones that spend crores of rupees for research and
development of new drugs. Had there not been
drug trials no new drugs would
have been invented and we would have mortality rates compared to stone age.

Also i agree that
most doctors endorse certain brands of drugs
( which i do not deny may be for
s ome financial gains also ) because thay have faith
in the quality of the
‘active drug’ of certain companies. Yes many local companies manufacture
generic products ( which is a copy of the original
molecule discovered by the
expensive company which can be used for
unaffordable patients. But you did not mention that
many of these generic drugs are of substandard quality and are the reason of
many uncalled for deaths due
to drug reactions. Most doctors would not want to
take responsibilty of the
quality of the ‘generic’ drugs.

Lastly, What do you
mean when you say ‘ People of high IQ and desire
to earn money should not
become doctors’.

Why arent doctors allowed to
have an ambition ??
How can a
person who earns 4 crores for an episode of a so called ‘social’ show decide on
what should be an individual’s ambition and
financial staus !!
Why can there be
no doctors who earn well for their professional
skills and do not indulge in
malpractices ?!

It just reflects your hypocrisy. I would like to offer
a few solutions to the problem.

 
Comment by DR. RAMESH VARDHAN
2012-06-07 09:13:27

hi amir, dr. sreedhar is ready for detailed discussion with you , come on pick up your bag & baggge hit the road \ first flight to bangalore. with team to shoot next episode. to prove —-doodh ka doodh , pani ka pani . dr.ramesh vardhan

 
Comment by Vallari
2012-06-07 09:26:18

In response to Dr Surinder Kumar Joshi

Why the Protests?

The protests are mostly because:

1. The criticism is coming from an outsider, a non-medical who himself is rolling in money.
I think so many Indians must have experienced the problem and if this issue was raised by Amir Khan, why there is so much of a problem. Anyone who had faced this problem can criticise so what does an outsider mean here? To raise any problem do you need to be in the same profession. If so, not a single Indian should complain about the politicians as all of us are not into politics. And the other thing is why doctors are looking at Aamir’s financial background.

2. Medical profession is being singled out. What about other professions? Which profession is clean, politicians, bureaucrats, police, engineers, judiciary, lawyers, accountants… who is clean and not corrupt?
It’s really upsetting to see the doctors giving justification like this. It clearly shows the level of humanity and honesty of serving the mankind. Doctors cannot play with anyone’s life. If the other professions are not corrupt doesn’t mean that we all should do the same and justify this way.

3. Entire profession is being painted black because of some black sheep. A large majority are good doctors doing a good job considering the amount of workload they are handling.
The show highlighted some common problems faced by our society. Amir never said that all the doctors are bad infact he himself appreciated and introduced us all with few good doctors. The doctors who are good and honest, they should not get offended by this show. If they are so much offended that clearly shows that they are not honest.
Regarding the amount of workload, we do agree that a doctor work 24/7 but is that a strict rule or compulsion for them to work. No, they work because they want to earn loads and loads of money.

4. The poor salaries that the doctors are paid. Mr Khan should know the princely salary (about Rs 20000/-) that an average doctor draws in India after getting his degree and even after PG (Rs 30 to 40 thousand). Impressive returns after investing 10 years of their life and almost a crore of their hard earned (or borrowed) money on their MBBS degree and further more on post-graduation!
The issue was raised so that conditions should be improved for a poor man, a common man, for medical students and for doctors as well. Our health ministry should wake up, Medical council of India (MCI) should wake up then only everyone will be benefitted.

5. The adverse conditions under which the doctors have to work, in terms of lack of equipment, trained manpower, and poor facilities.
In all the professions there is lack of equipment and poor facility. Ask a sweeper, ask a researcher, ask an engineer…………..one should be honest to his profession. These should not be the excuses.

I feel with Amir’s voice health ministry will wake up and help MCI and other people related to the medical profession do better in serving the mankind.

 
Comment by Ashutosh
2012-06-10 11:52:44

If somebody shows you dirt on your shirt, you should rush in to clean your shirt and not lead the person to show how many people are out there with more dirty shirts. Common sense.
And if you are so much concerned about the medical fraternity getting a bad name then u should invest ur energy and play ur role to clean up the system.

 
Comment by Maj Pankaj Rai
2012-06-11 18:11:36

Dr Sreedhara can leave India after trial is over. He and his colleague did an illegal tranplant surgery on a patient who trusted him suppressing the fact that the hospital does not have a license. The transplant surgeon was a member of the authorisation committee. He had never asked the patient for pancreas and suggested pancreas transplant a few hours before surgery by hiding the facts about the legality of the surgery. No post mortem was suggested. How does one know that organs were not taken out of the body and sold? Why was the cause of death described as natural and not reported to the government for 10 months? This doctor has betrayed the trust of patients and is now pretending to be innocent after washing his hands with the blood of patients and insulting the Hippocrates oath and suppressing facts/misrepresenting to gain false sympathy. These kind of doctors should get the maximun punishment of imprisonment prescribed under law so that it is a deterrent to others and in the interests of the patients of India. I have put a rejoinder to all his arguments. Why is that his management has now asked him to keep quiet. His langauge is unbecoming of a doctor and a doctor like him is a serious threat to patients of India. If the medical fraternity does not condemn such criminal acts citizens of India will go to High Court/Supreme Court for justice. Fortunately, in India black sheep in the medical fraternity are a minority who should be meted exemplary punishment.

Why has the Hon’ble High Court put a stay on organ transplant surgeries? Such blatant misrepresentation that registration for liver includes license to conduct transplant surgeries of the abdominal region? Next time, the learned doctor will transplant ovaries in a male human being and decsribe it as an emergency procedure. Shameful!

 
Comment by Saikumar G
2012-08-17 07:26:26

The status enjoyed by doctors some years back is no longer valid now. One reader wrote that doctors are next only to god but are public treating these doctors in that way? Everyone in other profession is trying to extract money from them when opportunity strikes.Eg.There is no emergency quota reservation for doctors in railways (Politicians and railway employees are given more importance),nobody does anything free to these next to gods! (They may charge more for these doctors for their services Eg.House construction,Painting,plumbing etc) The worse is the situation in government offices.Are they treating doctors as next to gods? and demanding money for their services?.Sometime back there was a tamil movie where doctors in a corporate hospital were shown treating a dead person.This incident was shown to highlight the fact that doctors are money minded. Public, government and court are treating doctors as traders and doctors are made to pay professional tax by the government and courts order compensation to the victims of medical negligence.New section of doctors are emerging who are ruthless and with lot of money/muscle power(Relatives of liquior barons,big businessmen,politicians,corrupt officials,cinema artists etc). Anybody with money power can become specialist or superspecialist now.Thanks to mushrooming of private medical colleges without adequate patients,staff and infrastructure.Public is going to face real threat once they are lured by the touts employed by these doctors.The difference is you can not attack them or protest against them as they are protected by the politicians and the media.The charges of corruption in medical profession is done mostly by those who themselves are corrupt and never helped a doctor. Those doctors who are serviceminded or following ethics are no longer recognised even by the public who are attracted by big buildings,advertisements and touts. It is better to enquire about the college in which doctor studied and go to a nearby doctor who feels accountable for his service.

 
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