Sometimes, doctors make mistakes and consumers file complaints. Some of the complaints are genuine as in case of Anuradha Saha decided by the Supreme Court, for medical negligence. But what about genuine and well trained doctors who care for the patient?
“Men who are occupied in the restoration of health to other men, by the joint exertion of skill and humanity, are above all the great of the earth. They even partake of divinity, since to preserve and renew is almost as noble as to create.”
Medical profession is a serious business and a noble one at that. We have obligations to society for the exalted position we enjoy. One must try and understand the medical profession within the context of the recent Supreme Court (SC) judgment that stirred up a hornet’s nest. I am happy that Anuradha Saha’s loss has been adequately compensated, but I’m also equally concerned that the SC judgment might further escalate the corporate sickness industry’s bills and might make it impossible for an ordinary person to get treatment. No one can question the wisdom of the learned judges who had to go by the evidence, while at same time kept their emotions at bay, to deliver their verdict. Rightly so! Now, the doctors’ indemnity insurance will go through the roof and many doctors will be unable to afford it, unless they join the corporate juggernaut.
Now, comes the dark side of the moon. Why should only doctors work in the villages, look after the poor and the downtrodden, round the clock without any time of their own? If a lawyer charges lakhs per hour of his/her time, the doctor is not supposed to charge like that? IIT, IIM and MBA graduates—most of them—leave the country immediately to work abroad. Nobody bothers about them but if a doctor wants to charge patients, people fault them. The tax payer pays for all of their education equally anyway, except for the ones who pay through their noses to get admission and degree at many of our (in)famous private universities. The bribe might run into crores these days.
We are all come under that same umbrella; no human being is infallible but why does society and the courts find fault for a wrong diagnosis? If my interpretation of the act is right, we are supposed to exercise due care to see that we do OUR best to the patient. Medical diagnosis is not as easy as it is made out in the press. There are no black and white areas in human physiology. Imponderables abound in the diagnostic arena. Even in the best centres in the world, where they pool the wisdom of many people in difficult cases, at least 12% of the patients’ medical diagnoses could only be made on the post-mortem table. No patient’s death can be predicted or prevented no matter how good a doctor is. It is very difficult to even give a right prognosis. No doctor can predict the unpredictable future of the patient although we have been doing that.
We are, to a great extent, responsible for this exponential growth of consumer cases against doctors. Firstly, we assumed greater powers than we really have and, many a time claim to do wonders. We are no longer humble enough to state that we only dress the wound and nature (God) heals. We have taken medicine to the market place to make big money. That has brought in its wake the market forces working in our area also. In truth, the medical world revolves around faith of the patient in his doctor. It is the confluence of two human beings—one who is ill or thinks he/she is ill comes to seek the advice of another in whom the first has confidence. This confidence works wonders even in healing. Unfortunately, this holy relationship between those two human beings no longer exists in corporate hospitals. It is like the assembly-line work. Modern medicine in this century has become a corporate monstrosity according to a study by Hillary Butler, in London.
As long as the doctor is sincere, he/she works very hard to get at the diagnosis, taking into account all the available data. But, the doctor should document all these efforts to show that he/she has done all that needs to be done for “reasonable care” of his/her patient. Of course, in all these cases, there should be no wanton negligence at any stage. Communication skills are vital in keeping the patient and his near and dear ones in the picture all through the time that the patient is under care. This would go a long way in avoiding unnecessary litigation.
A second opinion is another safeguard against litigation. In hindsight, one might be able to do better. However, in an emergency situation there is the added element of urgency to intervene which will not be there for the reviewing doctor, court or, a witness, for which the primary doctor is denied.
Another area where the problem gets complicated is the jealousy of our own brethren who might inadvertently create a situation where patient’s relatives become suspicious. If a patient’s health worsens and is then shifted to another hospital, then someone there might inadvertently say, “if only you had come early we would have been able to do lot for the patient.” This single sentence is the most important abettor of consumer complaints.
These days the massive bills generated in most corporate hospitals work as seeds for litigations to grow. In some instances, the grievances are genuine: Keeping dying patients in the intensive care units (ICUs), dead patients from wheeling dead patients into the ICUs, on ventilators, before being declared dead, admitting healthy people for all sorts of tests and scans, abdominal deliveries where normal delivery was feasible, operating on the wrong side or wrong limb, leaving operating instruments inside the patient’s body, administering dangerous wrong medications, all fall under the genuine list of consumer court complaints. However, complaints regarding the competence of a fully qualified and licensed doctor fall in the grey zone.
“Is it not also true that no physician, in so far as he is a physician, considers or enjoins what is for the physician's interest, but that all seek the good of their patients? For we have agreed that a physician strictly so called, is a ruler of bodies, and not a maker of money, have we not?”
-Plato (BC 427-BC 347)
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London.
The CBI court held both Rajesh and Nupur Talwar guilty for murdering their teen daughter Aarushi and their domestic help Hemraj at their home in May 2008
A Central Bureau of Investigation (CBI) court on Monday convicted dentist couple Rajesh and Nupur Talwar in the Aarushi-Hemraj double murder case.
According to lawyers, the dentist parents have been convicted of murder and destruction of evidence among other offences.
"We are deeply disappointed, hurt and anguished for being convicted for a crime that we have not committed. We refuse to fee defeated and will continue to fight for justice," the Talwar couple said in a statement issued after the verdict.
Nupur and Rajesh Talwar were found guilty of murdering their teen daughter Aarushi and their domestic help Hemraj at their home in May 2008.
Rajesh Talwar has also been convicted for filing a wrong first information report (FIR) with Noida police.
Writing for essay series, ‘Reimagining India’, Fareed Zakaria says Indians must embrace their common ambitions if the nation is to fulfil its tremendous potential
Fareed Zakaria, editor at Time magazine and host at CNN, while opining on India, feels that there is a birth of a new sense of nationhood in the country, drawn from the aspiring middle classes in its cities and towns, who are linked together by commerce and technology. “They have common aspirations and ambitions, a common Indian dream with rising standards of living, good government, and a celebration of India’s diversity. It is a powerful and durable base for a modern country that seeks to make its mark on the world,” he said, as a part of an essay series complied by McKinsey & Co under its ‘Reimagining India’ series.
Fareed Zakaria said, “Most of India’s wealth is generated from its cities and towns. Urban India accounts for almost 70% of the country’s GDP. But almost 70% of its people still live in rural India. Now, without central plan or direction, there are forces pushing India toward a greater sense of nationalism than before. Economic liberalization has created a national economy, and technology is creating a national culture. Technology is giving power to the people to make their voices heard, even when outnumbered by other interest groups. India is unusual in combining the growth of an emerging market with the openness of a freewheeling democracy.”
Giving an example of the states the host at CNN said, “State governments (in India) are aggressively promoting economic growth. Gujarat, the state of 60 million people has grown faster than China over the last two decades. India itself, for all its problems, has been one of the fastest-growing large economies in the world over that period.”
Fareed Zakaria said he believes that, “the country simply cannot reform at the pace necessary to fulfil its ambitions for growth and progress. Everything gets mired in political paralysis, and the governing class remains committed` to a politics of patronage and pandering. This is all true and deeply unfortunate. But it is a snapshot of today’s reality, not a moving picture of an evolving society.”
Courtesy: McKinsey & Co, Reimagining India