Even the Court has expressed concern about doctors performing too many tests on patients
This time, we put doctors, instead of lawyers, under the lens. And we have the tacit backing of the court.
As this is being typed, the author is recovering from a serious illness. It requires trips to the hospital and a series of tests; rather costly, but necessary to be put on the road to recovery. Friends phone or visit. Most have some advice or the other. They want to know the reason why many other tests ‘were not taken’.
A couple of days ago, the court remarked on how medical treatment is getting out of hand—with one test after the other. There is also talk about kickbacks from diagnostic centres encouraging doctors to recommend unnecessary tests. And, if you seek a second opinion, you will have to do the same tests all over again. True, very true. But the flip side needs be considered. Audi alteram partem.
Part of the reason for mounting expenses is the rise in instances of medical malpractice litigation. While, no doubt, people are being killed left, right and centre, and doctors are attacked at the drop of a hat, the issues are deeper. We will analyse them and then…
You be the judge
A day after the court’s observation came news of forced sterilisation that snuffed out many lives. There can be no excuse for that. Malpractice is a mild term for this type of manslaughter. Were preliminary tests taken? Doubtful; especially when the process was almost on an assembly-line basis. Some reports suggest the quality of antibiotics and pain-killers is under investigation.
Should not tests have been taken? In hindsight, most patients would have wanted them. But, at that particular moment, the women would have baulked. There would always be the burden of extra charges. The women had come for free tubectomy.
The problem with tests is this. Until a positive result is obtained, that is, until a disease, or some problem, is identified, tests have to continue. The doctor wants to be sure. He is fully aware of the Damocles’ sword hanging over him. He does not want to take risks. In other words, he does not want to be sued. Even though he has acted in good faith, he can be dragged over the coals and with a sensationalism-obsessed media barking at his heels, he wants to be doubly sure. Ergo, tests.
The past few weeks have been educative. The author is out of action and so is his lawyer.
A doctor’s son, the advocate, had to undergo many tests before he was on recovery street.
His assistant, a young newly-minted advocate, was down with dengue. Tests had to be performed to determine if it was not a run-of-the-mill fever. Without the tests, the boy and his doctor would have been in deep trouble.
You be the judge.
The court had bemoaned the lack of the family physician’s touch. Reminiscing about the time when the corner doctor seemed to cure all with a few coloured and foul-tasting ‘mixtures’, one wonders what happened to that world.
There were no malpractice suits, in those days. Docs did not get hammered by relatives venting their frustrations, often misplaced, on them. Hospitals were not overburdened.
The cities were cleaner and epidemics not rampant. Quinine and penicillin were enough to eliminate the most persistent bugs. Rifampicin v/s TB was in favour of the former.
Drug resistance was unheard of. Today, it is different.
So, should tests be taken or not? Yes and no, would be the best answer that we can come up with. Yet, a modicum of measured approach by doctors may well be needed. In the case of this sick author, only those tests that were deemed absolutely necessary were carried out. It was a step-by-step approach. In spite of the many tests that the friends recommended, the faith in the doctor was justified.
It’s a dicey situation.
You be the judge. When and how does one cross the thin red line?
(Bapoo Malcolm is a practising lawyer in Mumbai. Please email your comments to [email protected])
In the absence of strongly positive news, the market may drift lower
We had mentioned in Tuesday’s closing report that if NSE’s CNX Nifty does not make a lower low and closes above 8,560, bulls will regain control.
S&P BSE Sensex opened at 28,472, moved in the range of 28,371 and 28,505, and closed at 28,443 (down 1 point). Nifty opened at 8,529, moved between 8,508 and 8,547, and closed at 8,538 (up 13 points or 0.15%). NSE recorded a volume of 99.63 crore shares. India VIX fell 0.22% to close at 12.3675.
The market awaited the HSBC India Services PMI for November 2014 during the opening session. Indian services companies rose from 50 in October to 52.6 in November, the seasonally adjusted HSBC India Services PMI Business Activity Index. Service sector activity grew in November, as new business rose for the seventh month running.
Responding to the monetary policy statement issued by the Reserve Bank of India (RBI), the finance ministry said that the government looks forward to the central bank supporting the revival of growth and employment.
A high-level official panel headed by Parthasarathi Shome in its report submitted to the government on Tuesday said that there is no instrument at present that captures details of cash withdrawals from bank accounts, other than savings accounts. The availability of such information would help the Income Tax (I-T) department widen its information base on the use of black money since excessive cash withdrawal can help it understand the extent of the cash economy. The Panel recommended revision of Rule 114E of the Income Tax Act to include in its ambit cash withdrawals exceeding specified amounts in a day from bank accounts other than savings accounts. Alternatively, the banking cash transaction tax should be reinstated as an effective administrative measure, the committee said.
Coming back to markets, Essar Oil (20%) was the top gainer in ‘A’ group on the BSE today. The company was in news after its proposed delisting process had been put on hold following the direction from market regulator SEBI.
Ceat (5.39%) was the top loser in ‘A’ group on the BSE. The company today filed its shareholding pattern as on 28 November 2014 after its QIP issue. Promoter holding in the company has reduced to 50.76% from 57.11% as on 30 September 2014. FIIs holding increased to 25.27% from 15.65% while DIIs and retail shareholding reduced to 6.52% and 17.45%.
BHEL (2.50%) was among the top two gainers in Sensex 30 pack. The state-run company announced that it has commissioned India's first phase shifting transformer for the Kothagudem Thermal Power Station Stage-VI in Telangana.
Dr Reddy’s Lab (2.43%) was the top loser in Sensex 30 stock. The stock had hit its 52-week high on Monday.
On Tuesday, US indices closed in the green. In November, car and light truck sales in the US were second highest in eight years, according to figures from Autodata. Sales rose to a seasonally adjusted annual rate of 17.2 million, up from 16.5 million in October and the best level since August. In economic news, data released on Tuesday, 2 December 2014 showed construction spending grew more than estimated in October. Construction spending rose 1.1% in October to a seasonally adjusted annual rate of $971 million.
Asian indices showed mixed performance. Taiwan Weighted (1.55%) was the top gainer while KLSE Composite (1.56%) was the top loser.
The HSBC China services purchasing managers index rose to 53 in November from 52.9 in October, HSBC Holdings PLC said today. New orders in the service sector grew at their fastest pace in 30 months, compared with a much weaker showing in factory activity, HSBC said. China's official non-manufacturing purchasing managers' index rose to 53.9 in November from 53.8 in October, data from the China Federation of Logistics and Purchasing showed today.
European indices were showing mixed performance while US Futures were trading marginally lower.
The European Central Bank (ECB) will meet Wednesday to discuss monetary policy.
The uniform Bharat Bill Payment System will also help track all payments being made in economy, including cash payments to utilities, schools, and telcos among others
The Reserve Bank of India has issued final guidelines for the Bharat Bill Payment System (BBPS), which will help consumers pay multiple bills like electricity, telephone and school fees at a single point of transaction.
“The BBPS is an integrated bill payment system offering inter-operable and accessible bill payment service to customers through a network of agents, enabling multiple payment modes, and providing instant confirmation of payment,” the RBI said in a notification last week.
The RBI-promoted payment retail gateway and the issuer of the Rupay debit Cards, the National Payment Corporation of India (NPCI) has been appointed as the nodal body.
The apex banks has set a Rs100-crore net worth and domestic registration as qualifying conditions for those seeking to be authorised collection agents. RBI Governor Raghuram Rajan had first announced the central bank’s intention to set up BBPS in the second quarterly monetary policy review last year, after which a committee was constituted to suggest the way forward.
Based on the recommendations, it posted the draft guidelines on the same on 7th August.
The move will help track all the payments being made in economy, including cash payments to utilities, schools, and telcos among others.
Stressing on the need to have such a system in place, the RBI pointed to a 2013 estimate, which said over 30,800 million bills amounting to Rs6.22 lakh crore are generated each year in the top 20 cities alone.
The final guidelines came a day after the RBI came out with the final guidelines for licensing of payment and small banks.